Treatment of chronic hepatitis B virus infection in resource-constrained settings: expert panel consensus

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2010.02373.x/abstract

Treatment of chronic hepatitis B virus infection in resource-constrained

settings: expert panel consensus

T. Wiersma1, McMahon2, Jean-Michel Pawlotsky3, Chloe L. Thio4, Mark

Thursz5, Seng Gee Lim6, Ponsiano Ocama7, Gamal Esmat8, Mendy Maimuna9,

Bell10, Marco Vitoria11, Irina Eramova12, Lavanchy13, Geoff Dusheiko14

Article first published online: 28 NOV 2010

DOI: 10.1111/j.1478-3231.2010.02373.x

© 2010 Wiley & Sons A/S

Issue

Liver International

Volume 31, Issue 6, pages 755–761, July 2011

Corrected by:

Erratum: Erratum

Article first published online: 6 SEP 2011

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 informal World 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.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2010.02373.x/abstract

Treatment of chronic hepatitis B virus infection in resource-constrained

settings: expert panel consensus

T. Wiersma1, McMahon2, Jean-Michel Pawlotsky3, Chloe L. Thio4, Mark

Thursz5, Seng Gee Lim6, Ponsiano Ocama7, Gamal Esmat8, Mendy Maimuna9,

Bell10, Marco Vitoria11, Irina Eramova12, Lavanchy13, Geoff Dusheiko14

Article first published online: 28 NOV 2010

DOI: 10.1111/j.1478-3231.2010.02373.x

© 2010 Wiley & Sons A/S

Issue

Liver International

Volume 31, Issue 6, pages 755–761, July 2011

Corrected by:

Erratum: Erratum

Article first published online: 6 SEP 2011

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 informal World 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.