Review Article

Hepatology International

, Volume 2, Issue 3, pp 263-283

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2008 update

  • Yun-Fan LiawAffiliated withLiver Research Unit, Chang Gung University and Memorial Hospital Email author 
  • , Nancy LeungAffiliated withDepartment of Medicine, Alice Ho Miu Ling Nethersole Hospital
  • , Jia-Horng KaoAffiliated withHepatitis Research Center, National Taiwan University Hospital
  • , Teerha PiratvisuthAffiliated withNKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Prince of Songkla University
  • , Edward GaneAffiliated withNZ Liver Transplant Unit
  • , Kwang-Hyub HanAffiliated withDepartment of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center
  • , Richard GuanAffiliated withMount Elizabeth Medical Centre and National University Hospital Singapore
  • , George K. K. LauAffiliated withDepartment of Medicine, The University of Hong Kong
  • , Stephen LocarniniAffiliated withResearch & Molecular Development, Victorian Infectious Diseases Reference Laboratory, WHO Collaborating Centre for Virus Reference & Research
    • , for the Chronic Hepatitis B Guideline Working Party of the Asian-Pacific Association for the Study of the Liver


Large amounts of new data on the natural history and treatment of chronic hepatitis B virus (HBV) infection have become available since 2005. These include long-term follow-up studies in large community-based cohorts or asymptomatic subjects with chronic HBV infection, further studies on the role of HBV genotype/naturally occurring HBV mutations, treatment of drug resistance and new therapies. In addition, Pegylated interferon α2a, entecavir and telbivudine have been approved globally. To update HBV management guidelines, relevant new data were reviewed and assessed by experts from the region, and the significance of the reported findings were discussed and debated. The earlier “Asian-Pacific consensus statement on the management of chronic hepatitis B” was revised accordingly. The key terms used in the statement were also defined. The new guidelines include general management, special indications for liver biopsy in patients with persistently normal alanine aminotransferase, time to start or stop drug therapy, choice of drug to initiate therapy, when and how to monitor the patients during and after stopping drug therapy. Recommendations on the therapy of patients in special circumstances, including women in childbearing age, patients with antiviral drug resistance, concurrent viral infection, hepatic decompensation, patients receiving immune-suppressive medications or chemotherapy and patients in the setting of liver transplantation, are also included.


Chronic hepatitis B Liver cirrhosis Hepatocellular carcinoma Hepatitis B virus (HBV) Interferon-α Pegylated interferon Lamivudine Adefovir Entecavir Telbivudine