The objective of the practice guideline is to update the natural history of hepatitis B virus infection and to give recommendations for optimal management of chronic hepatitis B.<\/p>\n
The guideline is based on the best available evidence. The goal of treatment of chronic hepatitis B is to improve quality of life and survival by preventing progression of hepatitis to cirrhosis and hepatocellular carcinoma.<\/p>\n
The progression of liver disease is associated with HBV DNA level in the blood. In HBeAgpositive and HBeAg-negative patients, the ideal end-point of treatment is sustained HBsAg loss. Maintained undetectable HBV DNA under long-term antiviral treatment in HBeAg-positive patients who do not achieve antiHBe seroconversion and in HBeAg-negative patients is the next most desirable end point.<\/p>\n
Indication for treatment is identical for HBeAg-positive and HBeAg-negative patients and is based on a combination of serum HBV DNA level, ALAT elevation, and liver histology.<\/p>\n
Treatment should be considered in patients with HBV DNA level above 2000 IU\/ml, seerum ALAT level above the upper limit of normal, severity of liver disease, assessed by liver biopsy, showing moderate to severe active necroinfl ammation and\/or at least moderaate fibrosis. All patients with B-cirrhosis and positiive HBV DNA should be treated, regardless of their HBV DNA and ALAT level.<\/p>\n
Currently, there are two treatment strategies for both HBeAg-positive and HBeAgnegative chronic hepatitis B patients. Treatment can be of finite duration with pegylated interferon alfa2a or long-term continuous with entecavir or tenofovir disoproxil. Pegylated interferon alfa2a can be used for<\/p>\n
HBeAg-positive and HBeAg-negative chronic hepatitis B patients. Long-term treatment with entecavir or tenofovir disoproxil is necessary for patients with B-cirrhosis, for patients who fail with pegylated interferoon alfa2a to achieve virological response and require extended treatment, as well as for patients who have contraindications to pegylated interferon alfa2a treatment.<\/p>\n","protected":false},"excerpt":{"rendered":"
The objective of the practice guideline is to update the natural history of hepatitis B virus infection and to give recommendations for optimal management of chronic hepatitis B. The guideline is based on the best available evidence. The goal of treatment of chronic hepatitis B is to improve quality of life and survival by preventing …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"tags":[1538],"class_list":["post-5105","post","type-post","status-publish","format-standard","hentry","category-articles","tag-review","authors-benno-margus-en","authors-kai-zilmer-en","authors-kristi-ott-en","authors-matti-maimets-en","authors-riina-salupere-en"],"acf":[],"_links":{"self":[{"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/posts\/5105","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/comments?post=5105"}],"version-history":[{"count":1,"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/posts\/5105\/revisions"}],"predecessor-version":[{"id":5106,"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/posts\/5105\/revisions\/5106"}],"wp:attachment":[{"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/media?parent=5105"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/categories?post=5105"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/eestiarst.ee\/en\/wp-json\/wp\/v2\/tags?post=5105"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}