Chronic hepatitis B: treatment alert

Abstract: Chronic hepatitis B (CHB) is a serious global health concern, particularly in the Asia‐Pacific region. New information on the clinical management of CHB is emerging rapidly, requiring that physicians be alerted to updated treatment recommendations. The ACT‐HBV Asia‐Pacific Steering Committee members, composed of experts in hepatitis B from throughout the Asia‐Pacific region, reviewed and discussed new clinical data as reported in the literature or presented at recent international congresses, and recommended that physicians be alerted to updated treatment recommendations. Hepatitis B e antigen (HBeAg)‐positive patients with HBV DNA levels of ≥20 000 IU/ml (≥105 copies/ml) and elevated alanine aminotransferase levels should be considered for treatment. It is suggested that HBV DNA≥2000 IU/ml (≥104 copies/ml) is the more appropriate threshold for the treatment of HBeAg‐negative patients. Lamivudine, adefovir dipivoxil, interferon α‐2b, thymosin α‐1, and, most recently, entecavir, and pegylated interferon α‐2a are licensed for the management of CHB. The treatment recommendations from the 2005 Asian‐Pacific Consensus Statement on the Management of Chronic Hepatitis B have been updated to incorporate these new therapeutic options. A summary of treatment recommendations for special patient populations is also included.