Chronic hepatitis B virus infection

Lancet. 2018 Nov 24;392(10161):2313-2324. doi: 10.1016/S0140-6736(18)31865-8.

Abstract

Chronic hepatitis B virus infection is a global public health threat that causes considerable liver-related morbidity and mortality. It is acquired at birth or later via person-to-person transmission. Vaccination effectively prevents infection and chronic hepatitis B virus carriage. In chronically infected patients, an elevated serum hepatitis B virus DNA concentration is the main risk factor for disease progression, although there are other clinical and viral parameters that influence disease outcomes. In addition to liver biochemistry, virological markers, and abdominal ultrasonography, non-invasive assessment of liver fibrosis is emerging as an important assessment modality. Long-term nucleos(t)ide-analogue therapy is safe and well tolerated, achieves potent viral suppression, and reduces the incidence of liver-related complications. However, a need to optimise management remains. Promising novel therapies are at the developmental stage. With current vaccines, therapies, and an emphasis on improving linkage to care, WHO's goal of eliminating hepatitis B virus as a global health threat by 2030 is achievable.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • DNA, Viral / blood
  • Disease Progression
  • Female
  • Hepatitis B virus / drug effects*
  • Hepatitis B virus / genetics
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis B, Chronic / epidemiology*
  • Hepatitis B, Chronic / immunology
  • Hepatitis B, Chronic / mortality
  • Humans
  • Liver / chemistry
  • Liver / diagnostic imaging*
  • Liver / metabolism
  • Liver / pathology
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / drug therapy*
  • Liver Cirrhosis / pathology
  • Male
  • Middle Aged
  • Nucleosides / administration & dosage
  • Nucleosides / therapeutic use
  • Risk Factors
  • Ultrasonography / methods
  • Vaccination / methods
  • World Health Organization / organization & administration

Substances

  • DNA, Viral
  • Nucleosides