Treatment of chronic hepatitis B virus infection in resource-constrained settings: expert panel consensus
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Date
2011
Journal Title
Journal ISSN
Volume Title
Publisher
Liver International,
Abstract
Most of the estimated 350 million people with chronic hepatitis B virus (HBV)
infection live in resource-constrained settings. Up to 25% of those persons will
die prematurely of hepatocellular carcinoma (HCC) or cirrhosis. Universal
hepatitis B immunization programmes that target infants will have an impact
on HBV-related deaths several decades after their introduction. Antiviral
agents active against HBV are available; treatment of HBV infection in those
who need it has been shown to reduce the risk of HCC and death. It is
estimated that 20–30% of persons with HBV infection could benefit from
treatment. However, drugs active against HBV are not widely available or
utilized in persons infected with HBV. Currently recommended antiviral
agents used for treatment of human immunodeficiency virus (HIV) infection
do not adequately suppress HBV, which is of great concern for the estimated
10% of the HIV-infected persons in Africa who are co-infected with HBV.
Progressive liver disease has been shown to occur in co-infected persons whose
HBV infection is not suppressed. In view of these concerns, an informalWorld
Health Organization consultation of experts concluded that: chronic HBV is a
major public health problem in emerging nations; all HIV-infected persons
should be screened for HBV infection; HIV/HBV co-infected persons should
be treated with therapies active against both viruses and that reduce the risk of
resistance; standards for the management of chronic HBV infection should be
adapted to resource-constrained settings. In addition, a research agendum was
developed focusing on issues related to prevention and treatment of chronic
HBV in resource-constrained settings.
Description
Keywords
Hepatitis B, Resource-constrained settings, Treatment
Citation
Wiersma, S. T., McMahon, B., Pawlotsky, J. M., Thio, C. L., Thursz, M., Lim, S. G., ... & Dusheiko, G. (2011). Treatment of chronic hepatitis B virus infection in resource‐constrained settings: expert panel consensus. Liver International, 31(6), 755-761. DOI:10.1111/j.1478-3231.2010.02373.x