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

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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.

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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Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

MASLD with Sven Francque - Part 2

Pradeep Mundre

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

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UEG Mistakes In Articles

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Mistakes in the management of peritoneal malignancies and how to avoid them

Francesco Saverio Papadia, Matteo Santoliquido, Andrea Barberis, Tarkan Jäger, Charlotte Rabl

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Abstract

Peritoneal malignancies represent a complex and often misjudged clinical challenge. Historically synonymous with a terminal diagnosis, the advent of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) radically altered the prognosis for selected patients. However, progress has been jeopardised by a series of recurring and preventable errors in diagnosis, staging, and treatment selection. This article delineates the ten most critical pitfalls in managing peritoneal surface malignancies. For each pitfall, we provide evidence-based explanations, concrete clinical examples, and strategic recommendations for avoidance. We emphasise the pivotal role of early multidisciplinary discussion, precise imaging, and timely referral to high-volume expert centres to optimise patient outcomes and offer curative intent where previously there was none.

Topics

Digestive Oncology Surgery

Published

2026

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Patrizia Burra

UEG Podcast Episode

UEG Podcast

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MASLD with Sven Francque - Part 2

Sven Francque, Pradeep Mundre

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Abstract

Topics

Hepatobiliary

Published

2026

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Charlotte Rabl

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Pradeep Mundre

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Miroslav Vujasinovic

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Mistakes in transitional care for children and young adults and how to avoid them

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UEG Standards and Guidelines

Consensus

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International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

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Guideline

ABSTRACT

This international, multidisciplinary consensus report represents the first effort to systematically define and characterize fatty pancreas. A key outcome of this endeavor was the recommendation to adopt “fatty pancreas” as the standardized and inclusive term to describe all forms of fat accumulation in the pancreas. This terminological consensus provides a critical foundation for unified reporting and clinical communication. Another major contribution of the report is the consensus on diagnostic imaging findings, which was based on radiological and endoscopic modalities. The proposed criteria aim to enhance consistency in clinical assessment and support the development of standardized research protocols. In addition to establishing terminology and diagnostic frameworks, the report also synthesizes current knowledge across a wide range of relevant domains. These include the etiology and epidemiology of fatty pancreas, as well as its associations with alcohol consumption, smoking, acute and chronic pancreatitis, pancreatic exocrine insufficiency, type 2 diabetes mellitus, and surgical outcomes. The potential links between fatty pancreas and neoplastic conditions such as intraductal papillary mucinous neoplasms and pancreatic cancer are also addressed, alongside the current understanding of its metabolic implications (beta-cell function and glucose homeostasis) and treatment strategies. Throughout the consensus process, a consistent theme emerged: the limited availability of high-quality, prospective clinical data. Therefore, many of the recommendations in this report are based on expert consensus rather than strong empirical evidence. As such, the statements require rigorous prospective validation before they can be adopted into routine clinical practice. This underscores a critical need for further research, particularly studies aimed at clarifying causal relationships, validating diagnostic tools, and determining the clinical relevance of fatty pancreas across diverse patient populations. This report serves as both a summary of our current understanding and a roadmap for future investigations, aiming to close existing knowledge gaps and guide evidence-based clinical practice in this emerging field.

Publishers

European Society for Paediatric Gastroenterology, Hepatology and Nutrition, The European Society for Clinical Nutrition and Metabolism, European Society for Primary Care Gastroenterology, European Society of Pathology, European Society of Gastrointestinal Endoscopy, European Society of Gastrointestinal and Abdominal Radiology, European Association for the Study of the Liver, European Pancreatic Club

Guideline

Consensus

Topics

Pancreas

Citation

United European Gastroenterology Journal, 2026; 14:e70185

Published

2026

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Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Mistakes in transitional care for children and young adults and how to avoid them

Patrizia Burra

UEG Standards and Guidelines

Clinical Practice Guideline

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Endoscopic ultrasound-guided tissue sampling: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review

Antonio Facciorusso

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Guideline

Abstract

This Technical and Technology Review from the European Society of Gastrointestinal Endoscopy (ESGE) represents an update of the previous document on the technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including the available types of needle, technical aspects of tissue sampling, new devices, and specimen handling and processing. Among the most important new recommendations are:

ESGE recommends end-cutting fine-needle biopsy (FNB) needles over reverse-bevel FNB or fine-needle aspiration (FNA) needles for tissue sampling of solid pancreatic lesions; FNA may still have a role when rapid on-site evaluation (ROSE) is available.

ESGE recommends EUS-FNB or mucosal incision-assisted biopsy (MIAB) equally for tissue sampling of subepithelial lesions ≥20 mm in size. MIAB could represent the first choice for smaller lesions (<20 mm) if proper expertise is available.

ESGE does not recommend the use of antibiotic prophylaxis before EUS-guided tissue sampling of solid masses and EUS-FNA of pancreatic cystic lesions.

Publisher

European Society of Gastrointestinal Endoscopy

Guideline

Clinical Practice Guideline

Topics

Endoscopy

Citation

Endoscopy 2025; 57(04): 390-418

Published

2025

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Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

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Pradeep Mundre

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

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Antonio Facciorusso

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Mistakes in transitional care for children and young adults and how to avoid them

Patrizia Burra

UEG Mistakes In Articles

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Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

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Abstract

Alteration of common coagulation tests and thrombocytopenia represent an integral part of the clinical picture of patients with advanced chronic liver disease. As such, the International Normalised Ratio (INR) for prothrombin time is part of the Model for End-stage Liver Disease (MELD) score, which is commonly used to assess prognosis and the need for liver transplantation in patients with cirrhosis. Thrombocytopenia—being mainly related to hypersplenism and decreased synthesis of thrombopoietin by the liver—can also be used to identify the presence of portal hypertension and decreased liver function in patients with chronic liver disease.

Topics

Hepatobiliary

Citation

Giannini EG and Caldwell SH. Mistakes in coagulation in liver disease and how to avoid them. UEG Education 2021; 21: 29–34.

Published

2021

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Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

MASLD with Sven Francque - Part 2

Pradeep Mundre

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

Endoscopic ultrasound-guided tissue sampling: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review

Antonio Facciorusso

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Mistakes in transitional care for children and young adults and how to avoid them

Patrizia Burra

UEG Mistakes In Articles

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Mistakes in transitional care for children and young adults and how to avoid them

Patrizia Burra, Hans Törnblom, Jorge Amil Dias, Moriam Mustapha

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Abstract

Children and adolescents with chronic diseases requiring lifelong care face unique challenges that affect their daily lives and those of their families. Initially, these patients receive specialized care in pediatric facilities, where parents play a key role in treatment decisions. However, transitioning to adult healthcare facilities is inevitable, and this process, recognized as crucial years ago, involves moving adolescents with chronic conditions from child-centered to adult-oriented care. This transition can be complicated by varying age limits for pediatric care and the scarcity of adult care centers with specific expertise. The transition often requires cooperation between different centers or even countries due to patient mobility. The transition phase is critical, as it can lead to loss of follow-up, treatment suspension, and increased risks of complications or disease relapse. Beyond medical management, various factors influence the long-term prognosis of chronic conditions, making a well-organized transition program essential. While many hospitals have implemented transition models with mixed results in satisfaction, disease control, and follow-up adherence, there are frequent shortcomings in the process. This Mistakes In article will outline eight common mistakes made during the transition from pediatric to adult care, supported by literature and professional experience.

Topics

Primary Care

Citation

Jorge Amil-Dias, Hans Törnblom, Moriam Mustapha and Patrizia Burra. Mistakes in transitional care for children and young adults and how to avoid them. UEG Education 2023; 23: 22-25.

Published

2023

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