NIH Consensus on Management of Hepatitis B

The Annals of Int Medicine published the National Institutes of Health Consensus on Management of Hepatitis B (free full text). The main points are presented in an easy to understand question and answer format and some of them are summarized below.

What Is the Current Burden of Hepatitis B?

400 million people worldwide are living with chronic HBV infection.

Each year, 500 000 die of cirrhosis and hepatocellular carcinoma.

One million U.S. residents have chronic hepatitis B infection, 2,000-4000 deaths occur per year.

0.3-0.5% of U.S. residents have chronic infection, 47-70% of them are foreign-born.

What Is the Natural History of Hepatitis B?

A small proportion (less than 5%) of adults develop chronic HBV infection.

Chronic infection occurs in almost all children who are infected with hepatitis B during the perinatal period and in up to 50% of children who become infected between 1 and 5 years of age.

Lifelong monitoring is indicated.

What are the Therapeutic Options for Hepatitis B?

7 agents have been approved by the FDA, categorized as either interferons (interferon-2b and peginterferon-2a) or nucleoside or nucleotide analogues (lamivudine, adefovir, entecavir, tenofovir, and telbivudine).

The medications may be used as monotherapy or in combination.

National Institutes of Health Consensus Development Conference Statement: Management of Hepatitis B. Michael F. Sorrell et al. Annals of Int Medicine. 20 January 2009 | Volume 150 Issue 2.
Image source: A simplified drawing of the HBV particle and surface antigen, Wikipedia, public domain.

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