Mistakes in chronic hepatitis B management and how to avoid them

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Mistakes in chronic hepatitis B management and how to avoid them

Patrick Kennedy, Upkar S. Gill

Summary

AI Generated

Hepatitis B virus infection is the most common chronic viral infection globally, affecting more than 250 million people and causing over 850,000 deaths annually from cirrhosis and hepatocellular cancer.

HBV infection acquired at birth or in early childhood results in chronicity in greater than 95% of cases, whereas only 5–10% of adult-acquired infections progress to chronic infection.
HBV is transmitted haematogenously and sexually, with the majority of infections transmitted vertically or perinatally in high prevalence regions.
Despite the availability of a preventative vaccine, chronic HBV complications including cirrhosis and hepatocellular cancer account for more than 850,000 deaths per year.
This material provides foundational epidemiological context for clinicians managing or studying hepatitis B virus infection.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Stanaway JD, Flaxman AD, Naghavi M, et al. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet 2016; 388: 1081–1088. [Link]

Gill US and Kennedy PTF. The impact of currently licensed therapies on viral and immune responses in chronic hepatitis B: Considerations for future novel therapeutics. J Viral Hepat 2019; 26: 4–15. [Link]

Gill US and Kennedy PT. New insights in the management of chronic hepatitis B. Clin Med (Lond) 2015; 15: 191–196. [Link]

European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol 2017; 67: 370–398. [Link]

Prati D, Taioli E, Zanella A, et al. Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann Intern Med 2002; 137: 1–10. [Link]

Kennedy PT, Sandalova E, Jo J, et al. Preserved T-cell function in children and young adults with immune-tolerant chronic hepatitis B. Gastroenterology 2012; 143: 637–645. [Link]

Mason WS, Gill US, Litwin S, et al. HBV DNA integration and clonal hepatocyte expansion in chronic hepatitis B patients considered immune tolerant. Gastroenterology 2016; 151: 986–998.e4. [Link]

Invernizzi F, Vigano M, Grossi G, et al. The prognosis and management of inactive HBV carriers. Liver Int 2016; 36 (Suppl 1):100–104. [Link]

Yurdaydin C. Recent advances in managing hepatitis D. F1000Res 2017; 6: 1596. [Link]

10.

Townsend SA and Newsome PN. Mistakes in nonalcoholic fatty liver disease and how to avoid them. UEG Education 2017; 17: 39–41. [Link]

11.

Peleg N, Issachar A, Sneh-Arbib O, et al. Liver steatosis is a major predictor of poor outcomes in chronic hepatitis C patients with sustained virologic response. J Viral Hepat ePub ahead of print 27 Jun 2019. DOI: 10.1111/jvh.13167. [Link]

12.

Seto WK. Chronic hepatitis B and metabolic risk factors: A call for rigorous longitudinal studies. World J Gastroenterol 2019; 25: 282–286. [Link]

13.

Gill US, Zissimopoulos A, Al-Shamma S, et al. Assessment of bone mineral density in tenofovir-treated patients with chronic hepatitis B: can the fracture risk assessment tool identify those at greatest risk? J Infect Dis 2015; 211: 374–382. [Link]

14.

Gill US and Bertoletti A. Clinical trial design for immune-based therapy of hepatitis B virus. Semin Liver Dis 2017; 37: 85¬–94. [Link]

15.

Koffas A, Dolman GE and Kennedy PT. Hepatitis B virus reactivation in patients treated with immunosuppressive drugs: a practical guide for clinicians. Clin Med (Lond) 2018; 18: 212–218. [Link]

Abstract

Hepatitis B virus (HBV) infection is the most common chronic viral infection in the world. Despite the availability of a preventative vaccine, more than 250 million people worldwide are chronically infected with HBV. The complications of chronic HBV infection—cirrhosis and hepatocellular cancer (HCC)—account for more than 850,000 deaths per year. HBV is transmitted haematogenously and sexually, with the majority of HBV infections being transmitted vertically (or perinatally) in high prevalence regions. HBV infection acquired at birth or in early childhood results in chronicity in >95% of cases, whereas only 5–10% of those who are infected in adulthood will progress to chronic infection.

Topics

Hepatobiliary

Citation

Gill US and Kennedy PTF. Mistakes in chronic hepatitis B management and how to avoid them. UEG Education 2019; 19: 22–24

Published

2019

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