Hepatitis B Review Article Text

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1 division of gastroenterology and hepatology, department of medicine, stanford university medical center, 750 welch road, stanford, ca 94304, usa. [email protected]

background:

the indications and endpoints for treatment of chronic hepatitis b continue to evolve. The aim of the therapy for chronic hepatitis b is to achieve a long term continued suppression of the hepatitis b virus hbv dna to prevent disease progression leading to the development of cirrhosis and hepatocellular carcinoma. To summarise current literature on therapy of chronic hepatitis b, with a focus on indications for therapy, preferred treatment options, and management of resistance and partial responders.

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A systematic review of the literature, with a focus on international guidelines, was performed. Seven drugs are licensed for the treatment of chronic hepatitis b in many countries. The selection of a drug with high potency and low rate of resistance is essential to achieve rapid and long term viral suppression. The prevention of the sequelae of antiviral drug resistance and appropriate management of viral breakthrough are major goals of current management. The addition or change to an antiviral agent that is not cross resistant is critical to restore suppression of viral replication for patients with breakthrough resistance. Patient adherence to medication is essential to achieve adequate hbv dna suppression.

The current treatment strategy of chronic hepatitis b is now standard: initial selection of entecavir, tenofovir, or peginterferon alfa 2a. Future studies are required to determine if combination therapy using two oral agents or peginterferon with an oral agent with a high genetic barrier to resistance might be superior to standard current monotherapy. Hepatitis b more treatments, more testing, not enough data shamliyan ta, macdonald r, shaukat a, et al. Nonhospital health care associated hepatitis b and c virus transmission: united states, 1998 2008 thompson nd, perz jf, moorman ac, holmberg sd.

epidemiology and natural science

ly kn, xing j, klevens rm, jiles rb, ward jw, holmberg sd.

Medicine and the epidemic of incarceration in the united states rich jd, wakeman se, dickman sl. Diagnosis, management, and treatment of hepatitis c: an update ghany mg, strader db, thomas dl, et al. A functional genomic screen identifies cellular cofactors of hepatitis c virus replication tai aw, benita y, peng lf, et al. Elevated prevalence of hepatitis c infection in users of united states veterans medical centers morbidity and mortality weekly report, july 28, 20.

Transmission of hepatitis c virus infection through tattooing and piercing: a critical review tohme ra and holmberg sd. Preventive services task force recommendation statement morbidity and mortality weekly report: recommendations and reports, august 17, 2012 / 61 rr04 1 18 acip immunization update rein db, smith bd, wittenborn js, et al. Economic model of a birth cohort screening program for hepatitis c virus mcgarry lj, pawar vs, parekh hh, et al. Epub ahead of print hcv screening practices and prevalence in an mco, 20 2007 chou, r, et al.

clinical management

fried mw, navarro vj, afdhal n, et al silymarin in nash and c hepatitis synch study group. Pegylated interferon associated retinopathy is frequent in hcv patients with hypertension and justifies ophthalmologic screening vujosevic s, tempesta d, noventa f, et al.

Managing hepatitis c in the va health care system durfee jm, czarnogorski m, backus li, et al. Outcomes of treatment for hepatitis c virus infection by primary care providers arora s, thornton k, murata g, et al. Diagnosis, management, and treatment of hepatitis c: an update uto h, stuver so, hayashi k, et al. Risks of a range of alcohol intake on hepatitis c related fibrosis ferenci p, scherzer tm, kerschner h, et al. Ledipasvir and sofosbuvir for hcv in patients coinfected with hiv 1 h 233 zode c, asselah t, reddy kr, et al.

Sofosbuvir and velpatasvir for hcv in patients with decompensated cirrhosis curry mp, o'leary jg, bzowej n, et al astral 4 investigators. Sofosbuvir and velpatasvir for hcv genotype 1, 2, 4, 5, and 6 infection chahal hs, marseille ea, tice ja, et al. Epub ahead of print effectiveness of sofosbuvir based regimens in genotype 1 and 2 hepatitis c virus infection in 4026 u.s.

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Daclatasvir plus sofosbuvir for previously treated or untreated chronic hcv infection sulkowski ms, gardiner df, rodriguez torres m, et al ai4040 study group. Retreatment of hcv with abt 450/r ombitasvir and dasabuvir with ribavirin zeuzem s, jacobson im, baykal t, et al. Treatment of hcv with abt 450/r ombitasvir and dasabuvir with ribavirin feld jj, kowdley kv, coakley e, et al. Abt 450/r ombitasvir and dasabuvir with ribavirin for hepatitis c with cirrhosis andreone p, colombo mg, enejosa jv, et al. Abt 450/r ombitasvir and dasabuvir with or without ribavirin for hcv ferenci p1, bernstein d, lalezari j, et al pearl i study pearl iv study. Ledipasvir and sofosbuvir for 8 or 12 weeks for chronic hcv without cirrhosis kowdley kv, gordon sc, reddy kr, et al ion 1 investigators. Ledipasvir and sofosbuvir for previously treated hcv genotype 1 infection afdhal n, reddy kr, nelson dr, et al ion 1 investigators.

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