CMExpress

Clinical Roundtable Monograph: Improving HBV Treatment: Early Screening and Sustained Control for Improved Outcomes

Ira M. Jacobson, MD, Robert G. Gish, MD, and Paul J. Pockros, MD

Volume 4, Issue 1 , Supplement 1

Hepatitis B virus (HBV) infection is a disease of global public health concern, affecting more than 2 billion people worldwide. Although the majority of individuals infected with HBV experience acute disease and are able to recover from and clear the infection, chronic HBV infection occurs with incidence estimates ranging from 1.2 million to 2 million individuals in the United States alone. Global migration of individuals from regions with high rates of incidence play a part in escalating US prevalence. Chronic HBV infection confers increased risk for liver diseases, including cirrhosis and hepatocellular carcinoma (HCC). Disease occurs as a result of the immune response directed against the HBV infection, which triggers an ongoing wound-healing process and leads to tissue scarring and the development of fibrosis. HBV infection status can be determined by assaying for the presence of HBV DNA, indicative of active, replicating virus, the presence of HBV viral proteins (HBeAg, HBsAg, HBcAg), or the antibodies generated in response to these proteins (anti-HBe, anti-HBs, anti-HBc). The main treatments for chronic HBV infection include oral nucleoside or nucleotide analog antiviral drugs and interferon-based therapy. The aim of therapy is to effectively manage the disease and limit liver complications by suppressing HBV DNA, preferably to undetectable levels.

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