BACKGROUND: Chronic hepatitis B virus (HBV) infection and hepatitis delta virus (HDV) co-infection lead to liver cirrhosis, hepatic decompensation, and hepatocellular carcinoma (HCC). METHODS: We review the current knowledge of the management of HBV mono-infection and HBV/HDV co-infection with a special emphasis on liver cirrhosis. RESULTS: Treatment options for chronic hepatitis B are pegylated interferon (PEG-IFN) alfa and nucleos(t)ide analogues (NUC). PEG-IFN is a finite option to achieve hepatitis B surface antigen loss in compensated cirrhosis. However, this goal is rare. NUC are potent to achieve HBV DNA suppression but long-term treatment is mandatory in most cases. Long-term treatment with NUC can lead to reversion of liver cirrhosis, improve liver function, prevent liver transplantation, and reduces but does not eliminate the risk for development of HCC. Treatment options for hepatitis D are limited to PEG-IFN. Although late relapse is common, treatment with PEG-IFN reduces disease progression. However, new treatments are urgently needed for HDV infection. CONCLUSION: Early treatment of chronic hepatitis B and D is important to prevent complications of cirrhosis. HCC surveillance remains important in patients with cirrhosis.
BACKGROUND:Chronic hepatitis B virus (HBV) infection and hepatitis delta virus (HDV) co-infection lead to liver cirrhosis, hepatic decompensation, and hepatocellular carcinoma (HCC). METHODS: We review the current knowledge of the management of HBV mono-infection and HBV/HDV co-infection with a special emphasis on liver cirrhosis. RESULTS: Treatment options for chronic hepatitis B are pegylated interferon (PEG-IFN) alfa and nucleos(t)ide analogues (NUC). PEG-IFN is a finite option to achieve hepatitis B surface antigen loss in compensated cirrhosis. However, this goal is rare. NUC are potent to achieve HBV DNA suppression but long-term treatment is mandatory in most cases. Long-term treatment with NUC can lead to reversion of liver cirrhosis, improve liver function, prevent liver transplantation, and reduces but does not eliminate the risk for development of HCC. Treatment options for hepatitis D are limited to PEG-IFN. Although late relapse is common, treatment with PEG-IFN reduces disease progression. However, new treatments are urgently needed for HDV infection. CONCLUSION: Early treatment of chronic hepatitis B and D is important to prevent complications of cirrhosis. HCC surveillance remains important in patients with cirrhosis.
Authors: Jorg Petersen; Vlad Ratziu; Maria Buti; Harry L A Janssen; Ashley Brown; Pietro Lampertico; Jan Schollmeyer; Fabien Zoulim; Heiner Wedemeyer; Martina Sterneck; Thomas Berg; Christoph Sarrazin; Marc Lutgehetmann; Peter Buggisch Journal: J Hepatol Date: 2011-10-26 Impact factor: 25.083
Authors: Christopher Koh; Laetitia Canini; Harel Dahari; Xiongce Zhao; Susan L Uprichard; Vanessa Haynes-Williams; Mark A Winters; Gitanjali Subramanya; Stewart L Cooper; Peter Pinto; Erin F Wolff; Rachel Bishop; Ma Ai Thanda Han; Scott J Cotler; David E Kleiner; Onur Keskin; Ramazan Idilman; Cihan Yurdaydin; Jeffrey S Glenn; Theo Heller Journal: Lancet Infect Dis Date: 2015-07-16 Impact factor: 25.071
Authors: Christian M Lange; Jörg Bojunga; Wolf Peter Hofmann; Katrin Wunder; Ulrike Mihm; Stefan Zeuzem; Christoph Sarrazin Journal: Hepatology Date: 2009-12 Impact factor: 17.425
Authors: George Papatheodoridis; George Dalekos; Vana Sypsa; Cihan Yurdaydin; Maria Buti; John Goulis; Jose Luis Calleja; Heng Chi; Spilios Manolakopoulos; Giampaolo Mangia; Nikolaos Gatselis; Onur Keskin; Savvoula Savvidou; Juan de la Revilla; Bettina E Hansen; Ioannis Vlachogiannakos; Kostantinos Galanis; Ramazan Idilman; Massimo Colombo; Rafael Esteban; Harry L A Janssen; Pietro Lampertico Journal: J Hepatol Date: 2015-12-08 Impact factor: 25.083
Authors: Pauline Arends; Milan J Sonneveld; Roeland Zoutendijk; Ivana Carey; Ashley Brown; Massimo Fasano; David Mutimer; Katja Deterding; Jurriën G P Reijnders; Ye Oo; Jörg Petersen; Florian van Bömmel; Robert J de Knegt; Teresa Santantonio; Thomas Berg; Tania M Welzel; Heiner Wedemeyer; Maria Buti; Pierre Pradat; Fabien Zoulim; Bettina Hansen; Harry L A Janssen Journal: Gut Date: 2014-07-10 Impact factor: 23.059
Authors: Cesar Cabezas; Omar Trujillo; Ángel Gonzales-Vivanco; Carlos Manuel Benites Villafane; Johanna Balbuena; Alfredo Oswaldo Borda-Olivas; Magna Aurora Suarez-Jara; Flor de María Peceros; Max Carlos Ramírez-Soto Journal: PLoS One Date: 2020-06-15 Impact factor: 3.240