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Current Management of Chronic HBV Infection

  • Nese Inan
  • Fehmi Tabak
Chapter

Abstract

Hepatitis B virus (HBV) is a major health care problem that causes chronic infection to about 240 million people around the world. Chronic hepatitis B (CHB) is one of the main causes of end-stage liver diseases including liver failure and cirrhosis and hepatocellular carcinoma (HCC). Each year, around 780 thousand people are lost to HBV-related complications.

Although CHB treatment has started about 30 years ago, currently there are various treatment modalities for CHB: treatment with interferon (Peg-IFN) or with a nucleos(t)ide analogues (lamivudine, adefovir dipivoxil, entecavir, telbivudine, tenofovir disoproxil fumarate, tenofovir alafenamide). IFN-based treatment has an advantage of a limited duration treatment; on the other hand, nucleos(t)ide-based treatments have indefinite duration of therapy. Currently approved drugs which can control hepatic disease and suppress HBV may provide functional cure for CHB patients, but it is still impossible to mention complete cure. They prevent disease progression, development of cirrhosis and regression of fibrosis scores by suppression of replication of HBV. Unfortunately, HCC development can occur even in fully compliant patients. Updated international guidelines (AASLD, EASL, APASL) agreed on using more potent, low resistance drugs like entecavir, tenofovir disoproxil fumarate, tenofovir alafenamide or drugs having a definite duration of treatment like Peg-IFN.

There are many ongoing discussions on CHB treatment like personalized treatment, elimination of cccDNA and when to finalize therapy. This chapter aims to summarize and provide actual information about diagnosis, monitorization and treatment modalities of CHB.

Keywords

HBV CHB Nucleos(t)id analogues Interferon 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nese Inan
    • 1
  • Fehmi Tabak
    • 2
  1. 1.Department of Medical Microbiology, Faculty of MedicineBiruni UniversityIstanbulTurkey
  2. 2.Department of Infectious Diseases, Cerrahpasa School of MedicineIstanbul UniversityIstanbulTurkey

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