Treatment of chronic hepatitis B: Update of the recommendations from the 2007 Italian Workshop

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http://www.dldjournalonline.com/article/PIIS159086581000352X/abstract?rss=yes

JOURNAL OF DIGESTIVE AND LIVER DISEASE

Articles in Press

Treatment of chronic hepatitis B: Update of the recommendations from the 2007

Italian Workshop☆

Giampiero Carosia1, Rizzettob1, Alfredo Albertic2, Giuseppe Caritid2,

Massimo Colomboe2, Craxìf2, Gaetano Filiceg2, Massimo Levreroh2,

Francesco Mazzottai2, Giuseppe Pastorej2, Felice Piccininok2, e Pratil2,

Giovanni Raimondom2, Evangelista Sagnellik2, Totin2, Maurizia Brunettoo3,

Raffaele Brunog3, Vito Di Marcof3, Carlo Ferrarip3, Giovanni B. Gaetak3, Pietro

Lamperticoe3, Alfredo Marzanob3, Pollicinol3, Massimo Puotia3,

Santantonioj3, Antonina Smedilea3

published online 28 January 2011.

Corrected Proof

Abstract

The Italian recommendations for the therapy of hepatitis B virus (HBV)-related

disease were issued in 2008. Subsequently in 2008 the nucleotide analogue (NA)

Tenofovir was approved for antiviral treatment. The introduction of this

important new drug has called for the current guidelines update, which includes

some additional revisions: (a) the indication for therapy is extended to mild

liver fibrosis and the indication for treatment is graded as “possibleâ€,

“optional†or “mandatory†according to the fibrosis stage; ( two

different treatment strategies are described: first line definite duration

treatment with interferon, long-term treatment of indefinite duration with NA;

© the indication to follow either strategy is also based on the stage of liver

fibrosis; (d) virological monitoring is modified to include the definitions of

failure and of sustained virological response to interferon therapy; (e) the

recommendation to use HBV DNA assays with high sensitivity and wide linear

ranges is underlined (f) guidelines on post-treatment follow-up after finite

treatment with NA, potential side effects of therapy and non-virological

monitoring are defined; (g) definitions and treatment of patients without

optimal response to NA are reported; (f) treatment and monitoring of compensated

or decompensated cirrhosis and hepatocellular carcinoma are updated.

-------------------------------------------------------------------------

a Department of Infectious and Tropical Diseases, University of Brescia,

Brescia, Italy

b Department of Gastroenterology, University of Turin, Turin, Italy

c Department of Histology, Microbiology and Medical Biotechnologies, University

of Padova, Padova, Italy

d Department of Infectious Diseases, University of Turin, Turin, Italy

e Department of Gastroenterology, University of Milan, Milan, Italy

f Department of Gastroenterology, University of Palermo, Palermo, Italy

g Department of Infectious Diseases, University of Pavia, Pavia, Italy

h Department of Internal Medicine, University of Rome La Sapienza, Rome, Italy

i Department of Infectious Diseases, S.S. Annunziata Hospital, Antella, Firenze,

Italy

j Department of Infectious Diseases, University of Foggia, Italy

k Department of Infectious Diseases SUN, Napoli, Italy

l Unit of Clinical and Molecular Hepatology, Department of Internal Medicine,

University of Messina, Messina, Italy

m Blood Center Ospedale Alessandro Manzoni, Lecco, Italy

n Department of Infectious Diseases, Grosseto Hospital, Grosseto, Italy

o Gastroenterology and Hepatology Unit, University Hospital of Pisa, Pisa, Italy

p Unit of Infectious Diseases and Hepatology, Azienda Ospedaliero-Universitaria

di Parma, Parma, Italy

Corresponding author at: Department of Infectious Diseases, University of

Brescia, AO Spedali Civili, P.zzle Spedali Civili 1, 25123 Brescia, Italy. Tel.:

+39 0303995671; fax: +39 030303061.

☆ With the Endorsement of: Italian Association for the Study of The Liver

(Associazione Italiana per lo Studio del Fegato, AISF), Secretaries: e

Prati and Raffaele Bruno; Italian Society for the Study of Sexually Transmitted

Diseases (Società Interdisciplinare per lo Studio delle Malattie Sessualmente

Trasmissibili, SIMaST), President: Giampiero Carosi and Italian Society of

Infectious and Tropical Diseases (Società Italiana Malattie Infettive e

Tropicali, SIMIT) Presidents: Francesco Mazzotta and Evangelista Sagnelli.

1 Authors.

2 Jury.

3 Expert Panel.

PII: S1590-8658(10)00352-X

doi:10.1016/j.dld.2010.10.014

© 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc

All rights reserved.

*Note: Add-ons open in a new browser window. Please disable any pop-up blocking

software before viewing Add-ons.

[Guest guest]

http://www.dldjournalonline.com/article/PIIS159086581000352X/abstract?rss=yes

JOURNAL OF DIGESTIVE AND LIVER DISEASE

Articles in Press

Treatment of chronic hepatitis B: Update of the recommendations from the 2007

Italian Workshop☆

Giampiero Carosia1, Rizzettob1, Alfredo Albertic2, Giuseppe Caritid2,

Massimo Colomboe2, Craxìf2, Gaetano Filiceg2, Massimo Levreroh2,

Francesco Mazzottai2, Giuseppe Pastorej2, Felice Piccininok2, e Pratil2,

Giovanni Raimondom2, Evangelista Sagnellik2, Totin2, Maurizia Brunettoo3,

Raffaele Brunog3, Vito Di Marcof3, Carlo Ferrarip3, Giovanni B. Gaetak3, Pietro

Lamperticoe3, Alfredo Marzanob3, Pollicinol3, Massimo Puotia3,

Santantonioj3, Antonina Smedilea3

published online 28 January 2011.

Corrected Proof

Abstract

The Italian recommendations for the therapy of hepatitis B virus (HBV)-related

disease were issued in 2008. Subsequently in 2008 the nucleotide analogue (NA)

Tenofovir was approved for antiviral treatment. The introduction of this

important new drug has called for the current guidelines update, which includes

some additional revisions: (a) the indication for therapy is extended to mild

liver fibrosis and the indication for treatment is graded as “possibleâ€,

“optional†or “mandatory†according to the fibrosis stage; ( two

different treatment strategies are described: first line definite duration

treatment with interferon, long-term treatment of indefinite duration with NA;

© the indication to follow either strategy is also based on the stage of liver

fibrosis; (d) virological monitoring is modified to include the definitions of

failure and of sustained virological response to interferon therapy; (e) the

recommendation to use HBV DNA assays with high sensitivity and wide linear

ranges is underlined (f) guidelines on post-treatment follow-up after finite

treatment with NA, potential side effects of therapy and non-virological

monitoring are defined; (g) definitions and treatment of patients without

optimal response to NA are reported; (f) treatment and monitoring of compensated

or decompensated cirrhosis and hepatocellular carcinoma are updated.

-------------------------------------------------------------------------

a Department of Infectious and Tropical Diseases, University of Brescia,

Brescia, Italy

b Department of Gastroenterology, University of Turin, Turin, Italy

c Department of Histology, Microbiology and Medical Biotechnologies, University

of Padova, Padova, Italy

d Department of Infectious Diseases, University of Turin, Turin, Italy

e Department of Gastroenterology, University of Milan, Milan, Italy

f Department of Gastroenterology, University of Palermo, Palermo, Italy

g Department of Infectious Diseases, University of Pavia, Pavia, Italy

h Department of Internal Medicine, University of Rome La Sapienza, Rome, Italy

i Department of Infectious Diseases, S.S. Annunziata Hospital, Antella, Firenze,

Italy

j Department of Infectious Diseases, University of Foggia, Italy

k Department of Infectious Diseases SUN, Napoli, Italy

l Unit of Clinical and Molecular Hepatology, Department of Internal Medicine,

University of Messina, Messina, Italy

m Blood Center Ospedale Alessandro Manzoni, Lecco, Italy

n Department of Infectious Diseases, Grosseto Hospital, Grosseto, Italy

o Gastroenterology and Hepatology Unit, University Hospital of Pisa, Pisa, Italy

p Unit of Infectious Diseases and Hepatology, Azienda Ospedaliero-Universitaria

di Parma, Parma, Italy

Corresponding author at: Department of Infectious Diseases, University of

Brescia, AO Spedali Civili, P.zzle Spedali Civili 1, 25123 Brescia, Italy. Tel.:

+39 0303995671; fax: +39 030303061.

☆ With the Endorsement of: Italian Association for the Study of The Liver

(Associazione Italiana per lo Studio del Fegato, AISF), Secretaries: e

Prati and Raffaele Bruno; Italian Society for the Study of Sexually Transmitted

Diseases (Società Interdisciplinare per lo Studio delle Malattie Sessualmente

Trasmissibili, SIMaST), President: Giampiero Carosi and Italian Society of

Infectious and Tropical Diseases (Società Italiana Malattie Infettive e

Tropicali, SIMIT) Presidents: Francesco Mazzotta and Evangelista Sagnelli.

1 Authors.

2 Jury.

3 Expert Panel.

PII: S1590-8658(10)00352-X

doi:10.1016/j.dld.2010.10.014

© 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc

All rights reserved.

*Note: Add-ons open in a new browser window. Please disable any pop-up blocking

software before viewing Add-ons.