A Review on Therapeutic Management of Chronic Hepatitis B Infection
Journal Title: Archives of Clinical Gastroenterology - Year 2015, Vol 1, Issue 1
Abstract
The current therapeutic goal in the management of chronic hepatitis B (CHB) infection is to persistently suppress hepatitis B virus (HBV) replication and prevent its progression to liver failure and the development of hepatocellular carcinoma (HCC). At present, the therapeutic strategies for CHB includes either a short course of pegylated-interferon-alfa (PEG-IFNa) and/or a long term course of nucleos(t)ide analogues (NA’s). NA’s are more preferable to PEG-IFNa, majorly for its easier route of administration and excellent tolerance and safety profiles. Entecavir (ETV) and tenofovir (TDF) are the current first line options for its potency to maintain sustained virological response (SVR) in almost 100% of the adherent individuals along with minimal to no long-term resistance. These sustained inhibitions of HBV replication have been shown to be associated with histological improvement, modifying the long-term outcomes. However, HBsAg seroconversion, the best surrogate marker for viral clearance is still unachievable with the current first line agents and hence the risk for hepatocellular carcinoma (HCC) still exists among them. This makes us to still consider, a finite duration of PEG-IFNa that has shown considerable results with regards to HBsAg loss, as an attractive add-on or monotherapy option despite its adverse events profile. Existing evidences do not recommends its usage. However, numerous studies are ongoing and also further studies to evaluate the reliable baseline predictors of response to PEG-IFNa and early on-treatment stopping rules based on age, alanine aminotransferase levels (ALT), HBV DNA levels and HBsAg kinetics would be ideal.
Authors and Affiliations
Poongkunran Mugilan, Javaid Asad
Keywords
Related Articles
- EP ID EP325316
- DOI 10.17352/2455-2283.000006
- Views 148
- Downloads 0
Duodenal Eosinophilia and Gastroparesis: Is there a role?
Gastroparesis (GP) is a disorder that affects the motility of the stomach resulting in delayed gastric emptying (GE) without mechanical obstruction and has accompanying symptoms that include nausea, vomiting, early satie...
Helicobacter pylori Infection and Hematologic Disorders: what do We Really Know?
One of the most important events on gastroenterology certainly was the isolation of Helicobacter pylori (H. pylori) by Barry Marshall and Robin Warren in 1983 [1], occurrence which redirected our understanding of the pat...
Acute Pancreatitis, Actualization and Evidence Based Management
Acute pancreatitis (AP) is a systemic immunoinflammatory response to auto-digestion of the pancreas and peri-pancreatic organs. It is a frequent gastrointestinal disease with an important morbi-mortality, reaching 30% in...
The Effect on Gastric Emptying of Telaprevir-Based Triple Therapy for Chronic Hepatitis C Patients
Aim: We evaluated food intake in telaprevir-based triple therapy (telaprevir, pegylated-interferon, and ribavirin) and its relation to Gastric Emptying (GE). Methods: 17 patients received telaprevir combined with pegylat...
Long Pentraxin PTX 3 and Faecal Calprotectin as a Non Invasive Biomarkers for Ulcerative Colitis
Background and Study Aims: as there is no single golden rule for the diagnosis and activity of ulcerative colitis disease, this study is going to discuss the clinical relevance of calprotectin and PTX 3 in cases of ulcer...