Challenging Issues in the Management of Chronic Hepatitis B Virus, An Issue of Clinics in Liver Disease

1st Edition, Volume 25-4 - September 29, 2021
Editor: Mitchell L Shiffman
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 8 1 0 6 8 - 5
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 8 1 0 6 9 - 2

In this issue of Clinics in Liver Disease, guest editor Mitchell L Shiffman brings considerable expertise to the topic of Challenging Issues in the Management of Chronic Hepa… Read more

Challenging Issues in the Management of Chronic Hepatitis B Virus, An Issue of Clinics in Liver Disease

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In this issue of Clinics in Liver Disease, guest editor Mitchell L Shiffman brings considerable expertise to the topic of Challenging Issues in the Management of Chronic Hepatitis B Virus.

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Preface
The Changing Demographics of Hepatitis B Virus Infection
Key points
Introduction
Impact of recent immigration from Asia, Middle East, Africa and Central America to Europe, North America/USA, and Australia
The impact of vaccination on the incidence and prevalence of hepatitis B virus infection
Perspectives
Clinics care points
Interpretation of HBV Serologies
Key points
History of serologic testing. The Australia antigen
Review serologic tests used to detect HBV
Role of surface antigen
Role of HBV DNA testing
Role of HBV genotypes
Relationship of serology and HBV DNA to disease progression
Monitoring acute and chronic HBV with serologic testing
Mutations of HBV and how this may confuse serologic interpretation
Clinics care points
Disclosure
Treatment and Prevention of Acute Hepatitis B Virus
Key points
Incidence of acute hepatitis B virus
Clinical course
Preventing acute hepatitis B virus in adults
Preventing acute hepatitis B virus in newborns
Fulminant liver failure from acute hepatitis B virus
Indications for oral antiviral agents in acute hepatitis B virus
Is there harm in using antiviral therapy in early hepatitis B virus infection?
Summary
Clinics care points
Treatment of Chronic Hepatitis B Virus with Oral Anti-Viral Therapy
Key points
Indications for antiviral therapy
Role of Hepatitis B HBV DNA as the indication for antiviral therapy
Role of e antigen status in therapy
Results of oral antiviral therapy: a comparison of efficacy and side effects
What to do when oral antiviral therapy fails to decrease hepatitis B DNA to undetectable: Is there a role for combination therapy?
Switching to tenofovir disoproxil fumarate versus combination therapy
Switching to tenofovir alafenamide
Summary
Clinics care points
Controversies in Treating Chronic HBV: The Role of PEG-interferon-alfa
Key points
Introduction
Interferon and pegylated interferon for the treatment of chronic hepatitis B virus
E-antigen and S-antigen seroconversion with pegylated interferon versus oral antiviral therapy
Role of S-antigen titer in monitoring pegylated interferon treatment
Combining pegylated interferon and oral antiviral therapy
Patients who are the best candidates for pegylated interferon therapy consideration
Clinics care points
Disclosure
Controversies in Treating Chronic Hepatitis B virus: The Role of Hepatitis B Virus DNA and Surface Antigen Titer
Key points
Introduction
Should patients with high hepatitis B virus DNA levels but normal alanine aminotransferase levels be treated to prevent hepatocellular carcinoma?
Should patients with high hepatitis B virus DNA levels but normal alanine aminotransferase levels be treated to prevent reactivation and cirrhosis?
Can quantitative hepatitis B surface antigen and hepatitis B virus DNA help to identify which patients will remain inactive?
Can quantitative hepatitis B surface antigen be used to determine when to stop treatment?
Are baseline factors or on-treatment factors better to predict hepatitis B surface antigen seroclearance in patients?
Summary
Controversies in the Management of Hepatitis B: Hepatocellular Carcinoma
Key points
Introduction
Risk factors for hepatocellular carcinoma in hepatitis B infection
Incident risk of hepatocellular carcinoma in untreated hepatitis B
Impact of antiviral therapy on incident risk of hepatocellular carcinoma
Role of predictive risk scores for hepatocellular carcinoma in chronic hepatitis B
Should children with immune-tolerant disease be screened for hepatocellular carcinoma and at what interval
Target pediatric hepatitis B virus population for hepatocellular carcinoma surveillance
Tools used to screen for hepatocellular carcinoma in hepatitis B virus subjects
Should histologic severity affect the frequency of hepatocellular carcinoma screening
Factors influencing the frequency of hepatocellular carcinoma surveillance
Treatment of hepatitis B virus in patients who develop hepatocellular carcinoma not on hepatitis B virus therapy
Choice of nucleoside analogue therapy in managing hepatitis B virus–related hepatocellular carcinoma
Treatment of hepatitis B virus in patients who develop hepatocellular carcinoma while on anti–hepatitis B virus therapy
Summary
Clinics care points
Disclosures
Controversies in Treating Chronic Hepatitis B Virus Infection: Discordant Serologic Results
Key points
Introduction
Identifying chronic hepatitis B virus when serologic results are discordant
Summary
Clinics care points
Chronic Hepatitis B Virus in Patients with Chronic Hepatitis C Virus
Key points
Epidemiology of hepatitis B virus, hepatitis C virus, and coinfection
Interaction of hepatitis viruses
Treatment of hepatitis B virus and hepatitis C virus
Treatment of patients with hepatitis B virus–hepatitis C virus coinfection
Summary
New Treatments for Chronic Hepatitis B Virus/Hepatitis D Virus Infection
Key points
Introduction
Epidemiology and natural history of hepatitis D virus infection
Virology of hepatitis B virus/hepatitis D virus coinfection and serologic and virologic testing for hepatitis D virus
Interferon-based treatment of chronic hepatitis D virus infection
Novel treatments against hepatitis D virus infection
Clinics care points
Use of Hepatitis B Virus–Positive Organs in Organ Transplantation
Key points
Historical perspective
Hepatitis B testing of organ donors
Natural history and outcomes with use of anti–hepatitis B core antigen–positive, hepatitis B surface antigen–negative donors
Recommendations for use of anti-hepatitis B core antigen–positive, hepatitis B surface antigen–negative organs
Natural history and outcomes with the use of hepatitis B surface antigen–positive donors
Recommendations for use of hepatitis B surface antigen–positive organs
Can antiviral prophylaxis for hepatitis B virus after liver transplantation ever be stopped?
Vaccination in transplant candidates and recipients
Clinics care points
Disclosure
Hepatitis B and Health Care Workers
Key points
The risk of transmission of hepatitis B virus to health care workers: background and historical perpsectives
Vaccination of health care workers
The need for booster therapy
Hepatitis B virus vaccination failure in health care workers
Should hepatitis B virus screening and vaccination be mandatory for health care workers?
Health care workers with chronic hepatitis B virus
Summary
Clinics care points
Novel Therapies That May Cure Chronic Hepatitis B Virus
Key points
The hepatitis B virus
cccDNA and why it is so hard to eradicate
Endpoints of therapy and targeted populations
Proposed strategies for novel hepatitis B virus therapies
Drugs in development (phase I studies)
Summary
Clinics care points