Chronic hepatitis B: Treatment alert

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 ≥20000IU/ml (≥10⁵ copies/ml) and elevated alanine aminotransferase levels should be considered for treatment. It is suggested that HBV DNA≥2000IU/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.