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Management of Hepatitis B Infection

Stefan Zeuzem, MD
Program Director
Harry L. A. Janssen, MD, PhD
Milan J. Sonneveld, MD, PhD, MSc
Released: June 17, 2019
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Chronic HBV infection affects an estimated 257 million people globally, with the majority of infected patients residing in southeast Asia and sub-Saharan Africa.[1] High rates of chronic HBV infection are also found in the Amazon as well as southeast and central Europe, whereas lower rates (< 1%) are found in western Europe and North America. Prolonged infection with HBV may result in progression of liver disease from necroinflammation to fibrosis and cirrhosis and may also lead to the development of hepatocellular carcinoma and result in early death.[2] Successful anti-HBV therapy may reduce the probability of disease progression, and treatment guidelines from the American Association for the Study of Liver Diseases (AASLD)[3] and the European Association for the Study of the Liver (EASL)[4] therefore recommend treatment of chronic HBV infection in patients with persistent necroinflammation and viral replication. Current treatment guidelines recommend certain nucleos(t)ide analogues or peginterferon as first-line therapy options for treating chronic HBV infection. This module focuses on the appropriate management strategy for HBV-infected patients, as well as on how to modify treatment in the case of suboptimal response.

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