Current Management of Chronic Hepatitis B
Current Management of Chronic Hepatitis B
US Gastroenterology & Hepatology Review Volume 4 Issue 2
Published: October 2009
Published: October 2009
Despite significant recent advances in the diagnosis and treatment of viral hepatitis, chronic hepatitis B (CHB) remains a major public health matter. It is estimated that 350–400 million persons are infected with hepatitis B virus (HBV) worldwide.1,2 The prevalence of CHB in the US remains under-reported due to the continuous flux of immigrants from highly endemic areas into the US, and the failure to include the population of prisons in epidemiological studies. CHB predisposes patients to a lifetime risk for developing hepatocellular carcinoma (HCC) or cirrhosis.1,3,4 In addition, recent studies have shown a direct link between the level of serum HBV DNA and the risk for developing cirrhosis and HCC; the latter relationship is displayed in Figure 1.4 Therefore, early detection of chronic HBV infection and effective treatment that suppresses serum HBV DNA to low or undetectable levels has the potential to prevent disease progression to cirrhosis and cancer.
Prevention
The risk for chronicity of HBV infection depends on the time of acquisition. While infection at birth can result in a risk for development of CHB of 90%, infection in adulthood results in only 5% risk.5,6 Vaccination is the best preventive measure against acquisition of acute and chronic hepatitis B. There has been a 78% decline in the incidence of acute hepatitis B from 1990 to 2005, a period marked by broadening the indications for HBV vaccination as well as other public health measures by the Centers for Disease Control and Prevention (CDC).7 Three main strategies have been promoted to decrease the risk for HBV infection:
- screening of all pregnant women and vaccination of all infants born to infected mothers;
- routine childhood catch-up vaccination of adolescents; and
- vaccination of high-risk individuals (see Table 1).
To read full article please click here
Keywords:
Chronic Hepatitis B, HBV infection, Vaccination,
Chronic Hepatitis B, HBV infection, Vaccination,
