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Open Access Green as soon as Postprint is submitted to ZB.
Scientific and medical evidence informing expansion of hepatitis B treatment guidelines.
Lancet Gastroenterol. Hepatol. 10, 941-951 (2025)
Chronic hepatitis B treatment relies on nucleoside or nucleotide analogue drugs that suppress hepatitis B virus (HBV) replication, normalise liver enzymes, and slow disease progression with excellent safety profiles. Treatment is not curative, and patients remain at risk of cirrhosis and hepatocellular carcinoma. Treatment guidelines have generally restricted antiviral therapy to individuals with high HBV DNA and elevated ALT or hepatic fibrosis, often requiring longitudinal testing that can be scarcely available in resource-limited settings. Consequently, fewer than 3% of people living with HBV infection are receiving antiviral therapy. Guidelines from China and WHO recently broadened access criteria to antiviral therapy, but there are people who fall outside these guidelines who could still benefit from treatment initiation. The pathological processes induced by HBV infection are still active in these patients. We present the benefits and risks of expanding treatment eligibility. We believe that the benefits of reduced hepatic damage and carcinogenic stimuli greatly outweigh the risks.
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Publication type
Article: Journal article
Document type
Review
Keywords
Closed Circular Dna; Regulatory T-cells; Immune-tolerant; Hepatocellular-carcinoma; Antiviral Therapy; Natural-history; Liver; Infection; Risk; Interferon
ISSN (print) / ISBN
2468-1253
e-ISSN
2468-1253
Quellenangaben
Volume: 10,
Issue: 10,
Pages: 941-951
Publisher
Elsevier
Publishing Place
London
Institute(s)
Institute of Virology (VIRO)