JSH Guidelines for the Management of Hepatitis B Virus Infection

,

doi:10.1111/hepr.12269

Cited by 137 publications

(37 citation statements)

References 345 publications

(881 reference statements)

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“…The best surrogate markers for antiviral treatment against HBV are HBsAg as a long-term marker as well as sustained normalization of the serum ALT level, negative serum HBV DNA level and negative HBeAg as short-term markers [16] .…”

Section: Cirrhosismentioning

confidence: 99%

“…For acute-on-chronic liver failure and HCC, the risk factors are obvious and antiviral therapies could reduce the risk of developing acute-on-chronic liver failure and HCC [16] . In general, the indication and selection of antiviral therapies for persistent HBV infection is decided according to the age, disease phase, fibrosis stage and inflammatory activity of the liver, and risk of disease progression.…”

Section: Introductionmentioning

confidence: 99%

“…In young patients with HBeAg-positive chronic hepatitis and elevated serum ALT levels, there is a 7%-16% possibility of HBeAg-negative conversion. Then, strict observation without treatment may be chosen if there is no advanced fibrosis or possibility of fulminant hepatitis [16] .…”

Section: Introductionmentioning

confidence: 99%

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Current and future directions for treating hepatitis B virus infection

Tawada

Yokosuka

2015

WJH

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Hepatitis B virus (HBV) persistently infects approximately 350 million people, and approximately 600000 liverrelated deaths are observed per year worldwide. HBV infection is also one of the major risk factors for hepatocellular carcinoma (HCC). The persistence of serum hepatitis B e antigen (HBeAg) and high level of serum HBV DNA are thought to reflect a high HBV replication status in hepatocytes, causing cirrhosis, HCC and liver-related deaths. It has been reported that antiviral therapy, such as peginterferon and nucleos(t)ide analogues (NUCs), could suppress liver-related death by inhibiting the HBV DNA levels and inducing seroconversion from HBeAg to antibody to HBe antigen. Currently, peginterferon is widely used, but there are also several disadvantages in the use of peginterferon, such as various adverse events, the administration route and duration. It is difficult to predict the effects of treatment and interferon is contraindicated for the patients with advanced fibrosis of the liver and cirrhosis. With respect to NUCs, entecavir and tenofovir disoproxil fumarate are current the first-choice drugs. NUCs can be administered orally, and their anti-viral effects are stronger than that of peginterferon. However, because cessation of NUC administration leads to high levels of viral replication and causes severe hepatitis, they must be administered for a long time. On the other hand, the use of both interferon and NUCs cannot eliminate covalently closed circular DNA of HBV. In this review, we evaluate the natural course of chronic HBV infection and then provide an outline of these representative drugs, such as peginterferon, entecavir and tenofovir disoproxil fumarate.

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Section: Cirrhosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current and future directions for treating hepatitis B virus infection

Tawada

Yokosuka

2015

WJH

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“…Based on the above two results, the JSH suggests that ETV therapy suppresses hepatocarcinogenesis [9]. …”

Section: Antiviral Effect Of Namentioning

confidence: 99%

“…In addition, we summarize the recent developments in the management of CHB based on the recent available data, results, and reviews [6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

Recent Advances in the Management of Chronic Hepatitis B Including Suppression of Hepatocellular Carcinoma by Entecavir and Interferon

Kim

Kim²,

Imoto³

et al. 2015

Oncology

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At present, for adults with chronic hepatitis B virus (HBV) infection, two new analogues, entecavir (ETV) and tenofovir, are recommended as the first-line therapy by the EASL (European Association for the Study of the Liver), AASLD (American Association for the Study of Liver Diseases), and APASL (Asian Paciﬁc Association for the Study of the Liver) guidelines. The use of pegylated interferon-α (PEG IFN-α) is recommended as the first-line therapy instead of standard IFN-α according to the above 3 guidelines. In this paper, the aim was to assess: (1) the long-term efficacy and safety as well as the resistance to ETV and tenofovir disoproxil fumarate (TDF); (2) the efficacy of PEG IFN-α; (3) the role of combination therapy with IFN plus two analogues, such as lamivudine and ETV; (4) the efficacy and safety of two analogues with cirrhosis, and (5) suppression of hepatocellular carcinoma (HCC) by ETV and IFN treatment. The results are as follows: (1) both ETV and TDF showed long-term efficacy and safety; (2) PEG IFN-α resulted in a greater decline in HBV DNA levels and a higher rate of HBeAg seroconversion; (3) combination therapy with IFN plus two analogues did not elevate the rate of sustained responses; (4) both ETV and TDF showed efficacy and safety with cirrhosis (ETV especially displayed efficacy and safety with decompensated cirrhosis), and (5) suppression of HCC was observed by ETV and IFN.

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