Improving outcomes for patients with chronic hepatitis B

The ultimate goal in managing patients with chronic hepatitis B (CHB) is to improve long-term outcomes by decreasing deaths and liver transplantation procedures due to hepatitis B virus (HBV)-related cirrhosis and hepatocellular carcinoma. Active intervention and vaccination of individuals susceptib...

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Bibliographic Details
Published in:Current gastroenterology reports 2007-03, Vol.9 (1), p.14-22
Main Author: Gish, Robert G
Format: Article
Language:English
Subjects:
Adenine - analogs & derivatives
Adenine - therapeutic use
Antiviral Agents - therapeutic use
Drug Resistance, Viral
Guanine - analogs & derivatives
Guanine - therapeutic use
Hepatitis B Vaccines
Hepatitis B, Chronic - drug therapy
Hepatitis B, Chronic - prevention & control
Humans
Interferon-alpha - therapeutic use
Lamivudine - therapeutic use
Nucleosides - therapeutic use
Organophosphonates - therapeutic use
Polyethylene Glycols - therapeutic use
Pyrimidinones - therapeutic use
Recombinant Proteins
Thymidine - analogs & derivatives
Treatment Outcome
Viral Load
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Summary:The ultimate goal in managing patients with chronic hepatitis B (CHB) is to improve long-term outcomes by decreasing deaths and liver transplantation procedures due to hepatitis B virus (HBV)-related cirrhosis and hepatocellular carcinoma. Active intervention and vaccination of individuals susceptible to HBV infection are key steps to decrease the risk of this global public health problem. Large studies have demonstrated that long-term outcomes of CHB are tied to serum levels of HBV DNA. New oral treatments, characterized by potent antiviral effects, good tolerability, improved histology, stable seroconversion, and minimal resistance, are available. Long-term data with oral medications have shown decreased rates of liver cancer development, liver disease reversal, and progression to liver failure. Pegylated interferon trials have demonstrated modest rates of hepatitis B e antigen seroconversion and improved histology after treatment. This paper describes ways to improve outcomes of CHB using vaccines, interferon, lamivudine, adefovir, and newer agents.
ISSN:1522-8037
1534-312X
DOI:10.1007/s11894-008-0016-9