Management of Chronic Hepatitis B Virus Infection

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Chronic hepatitis B virus (HBV) infection remains a burden to many countries worldwide as it is one of the leading cause of end-stage liver disease and mortality[1-2]. Approximately one-third of the world’s population has had a past HBV infection while 350 to 400 million people are chronically infected with HBV[1-3]. However, the Institute of Medicine Committee states that 65% of these chronically infected HBV patients are not aware of their infection as it shows no symptoms until it has reached advanced stages of liver disease. Since HBV can be asymptomatic at initial stages, screening and blood tests are carried out to initiate early treatment options for the patients. The current treatments available for HBV management is interferon alfa therapy, nucleoside and nucleosite analogue therapy.

One of the treatments available for HBV patients is interferon alfa therapy. It is administered subcutaneously. There are two types of interferon therapy which is standard (IFN) and pegylated (PEG-IFN) interferon alfa therapy. According to Bhattacharya et al[1], although both treatments aim to limit viral propagation in patients with either positive or negative hepatitis B antigen, it is reported that PEG-IFN is preferred as it is found to decrease HBV DNA level more than IFN. Similarly, Papatheodoridis G et al[2] also agrees that PEG-IFN is preferred over IFN. In fact, the report states that IFN is being replaced by PEG-IFN as PEG-IFN lack antiviral resistance and is able to maintain an undetectable level of HBA DNA in sustained off-treatment response[2]. Not only that, PEG-IFN is more patient-friendly as it is only administered once weekly compared to IFN which has to be administered several times a week. However, PEG-IFN is not suitable...

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...treat HBV, only a few agents are proven to be effective and safe as “viral resistance limits their long-term success” as quoted by Scaglione S[3]. It is clear that further studies have to be done in order to overcome the resistance barrier of the virus. Not only that, healthcare sectors should work on educating the public so that they are fully aware of the management of HBV.

Works Cited

Bhattacharya D, Thio C. Review of hepatitis B therapeutics. Clinical infectious diseases. 2010;51(10):1201--1208.
2. Papatheodoridis G, Buti M, Cornberg M, LA H, Janssen D, Pol S et al. Corrigendum to:‘‘EASL clinical practice guidelines: Management of chronic hepatitis B virus infection’’[J Hepatol 2012; 57: 167--185]. Journal of Hepatology. 2013;58:201.
3. Scaglione S, Lok A. Effectiveness of hepatitis B treatment in clinical practice. Gastroenterology. 2012;142(6):1360--1368.

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