Chronic hepatitis B virus infection

Chronic hepatitis B virus infection is a global public health threat that causes considerable liver-related morbidity and mortality. It is acquired at birth or later via person-to-person transmission. Vaccination effectively prevents infection and chronic hepatitis B virus carriage. In chronically i...

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Bibliographic Details
Published in:The Lancet (British edition) 2018-11, Vol.392 (10161), p.2313-2324
Main Authors: Seto, Wai-Kay, Lo, Ying-Ru, Pawlotsky, Jean-Michel, Yuen, Man-Fung
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Chronic infection
Deoxyribonucleic acid
Developmental stages
Disease Progression
DNA
DNA, Viral - blood
Drug dosages
Epidemiology
Female
Fibrosis
Genomes
Global health
Health risks
Hepatitis
Hepatitis B
Hepatitis B virus - drug effects
Hepatitis B virus - genetics
Hepatitis B, Chronic - drug therapy
Hepatitis B, Chronic - epidemiology
Hepatitis B, Chronic - immunology
Hepatitis B, Chronic - mortality
Hepatitis delta virus
Humans
Immunization
Infections
Liver
Liver - chemistry
Liver - diagnostic imaging
Liver - metabolism
Liver - pathology
Liver Cirrhosis - diagnostic imaging
Liver Cirrhosis - drug therapy
Liver Cirrhosis - pathology
Male
Middle Aged
Morbidity
Nucleosides - administration & dosage
Nucleosides - therapeutic use
Public health
Risk analysis
Risk Factors
Ultrasonography - methods
Ultrasound
Vaccination - methods
Vaccines
Viruses
World Health Organization - organization & administration
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Description
Summary:Chronic hepatitis B virus infection is a global public health threat that causes considerable liver-related morbidity and mortality. It is acquired at birth or later via person-to-person transmission. Vaccination effectively prevents infection and chronic hepatitis B virus carriage. In chronically infected patients, an elevated serum hepatitis B virus DNA concentration is the main risk factor for disease progression, although there are other clinical and viral parameters that influence disease outcomes. In addition to liver biochemistry, virological markers, and abdominal ultrasonography, non-invasive assessment of liver fibrosis is emerging as an important assessment modality. Long-term nucleos(t)ide-analogue therapy is safe and well tolerated, achieves potent viral suppression, and reduces the incidence of liver-related complications. However, a need to optimise management remains. Promising novel therapies are at the developmental stage. With current vaccines, therapies, and an emphasis on improving linkage to care, WHO's goal of eliminating hepatitis B virus as a global health threat by 2030 is achievable.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(18)31865-8