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Management of HBV and HBV/HDV-Associated Liver Cirrhosis
#MMPMID27413725
Höner Zu Siederdissen C
; Cornberg M
Visc Med
2016[Apr]; 32
(2
): 86-94
PMID27413725
show ga
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.
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