Latest updates on chronic viral hepatitis B

ABSTRACT Hepatitis B virus (HBV) remains a major cause of liver-related morbidity and mortality in Turkey and all over the world. Two different types of antiviral agents can be used in the treatment of chronic hepatitis B (CHB). Conventional (IFN) or pegylated interferon alpha (PegIFN), nucleoside [lamivudine (LMV), telbivudine, emtricitabine, entecavir (ETV)] and nucleotide analogs [adefovir dipivoxil (ADV)] and tenofovir disoproxil fumarate (TDF)]. Antiviral agent must ensure a degree of HBV viral suppression and will lead to biochemical, serological remission and histological improvement. Current treatment strategies are discussed in present brief report. Keywords: Chronic hepatitis B, Nucleos(t)ide analog, Entecavir, Tenofovir disoproxil fumarate ÖZ Hepatit B Türkiye’de ve dünyada major bir sağlık problem olup karaciğer hastalıklarına bağlı morbidite ve mortalitede önemli bir yer tutmaktadır. İnterferonlar ve oral anti-viral ajanlar olan nukleotid ve nükleozid analogları tedavide uygulanmaktadır. Bu derlemede tedavi rejimleri, uygulamaları ve sonuçları ayrıntılı olarak belirtilmiştir. Anahtar kelimeler: Kronik hepatit B, Nükleoz(t)id analog, Entekavir, Tenofovir disoproksil fumarat Introduction Hepatitis B virus (HBV) remains a major cause of liverrelated morbidity and mortality in Turkey. Morbidity and mortality are linked to persistence of viral replication and evolution to end-stage liver disease. Viral suppression with antiviral therapy has achieved clinical benefits as a result of prevention of disease progression, reduction in hepatic decompensation in chronic hepatitis B (CHB) patients. There have been great evolutions in the management of CHB infection. The aim of this present review was to focus on latest updates on the management of CHB infection. Epidemiology An estimated 350 million individuals are chronically infected with HBV in worldwide [1]. In Turkey, Hepatitis B surface antigen (HBsAg) positivity was 4% based on the result of an epidemiological study [2]. HBV infection is present in approximately 50% of the patients with hepatocellular cancer (HCC), most of whom have cirrhosis. In 2013, HBVrelated end-stage liver disease with/without HCC accounted for approximately 40-50% of cases of liver transplantation in Turkey. The spectrum of HBV-related disease is variable, ranging from an inactive HBV carrier state to progressive CHB, which may evolve to cirrhosis and its complications such as portal hypertension or HCC. Every year, around 1 million individuals die as a result of HBV-related end stage liver disease and its complications [3]. Continues...