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Practice Guideline
. 2012 Dec;26(12):917-38.
doi: 10.1155/2012/506819.

Management of chronic hepatitis B: Canadian Association for the Study of the Liver consensus guidelines

Carla S Coffin  1 , Scott K Fung, Mang M Ma; Canadian Association for the Study of the Liver
Affiliations
Practice Guideline

Management of chronic hepatitis B: Canadian Association for the Study of the Liver consensus guidelines

Carla S Coffin et al. Can J Gastroenterol. 2012 Dec.

Abstract
in English, French

Chronic hepatitis B (CHB) is a dynamic disease that is influenced by host and virological factors. The management of CHB has become more complex with the increasing use of long-term oral nucleos⁄tide analogue antiviral therapies and the availability of novel diagnostic assays. Furthermore, there is often a lack of robust data to guide optimal management such as the selection of therapy, duration of treatment, potential antiviral side effects and the treatment of special populations. In November 2011, the Canadian Liver Foundation and the Canadian Association for the Study of the Liver convened a consensus conference to review the literature and analyze published data, including other international expert guidelines on CHB management. The proceedings of the consensus conference are summarized and provide updated clinical practice guidelines to assist Canadian health care providers in the prevention, diagnosis, assessment and treatment of CHB.

L’hépatite B chronique (HBC) est une maladie dynamique influencée par l’hôte et les facteurs virologiques. La prise en charge de l’HBC s’est compliquée avec l’utilisation accrue des analogues de nucléosides et de nucléotides antiviraux sur une longue période et la disponibilité de méthodes diagnostiques novatrices. De plus, on manque souvent de données solides pour orienter une prise en charge optimale, telle que la sélection de la thérapie, la durée du traitement, les effets secondaires potentiels des antiviraux et le traitement des populations particulières. En novembre 2011, la Fondation canadienne du foie et l’Association canadienne pour l’étude du foie ont organisé une conférence consensuelle pour procéder à une analyse de la bibliographie et des données publiées, y compris d’autres lignes directrices internationales d’experts sur la prise en charge de l’HBC. Les débats de la conférence consensuelle sont résumés et donnent lieu à une mise à jour des lignes directrices cliniques pour aider les dispensateurs de soins canadiens à prévenir, diagnostiquer, évaluer et traiter l’HBC.

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Figures

Figure 1)
Figure 1)
A Algorithm for selecting hepatitis B e antigen (HBeAg)-positive patients for treatment. B Algorithm for selecting HBeAg-negative patients for treatment. ALT Alanine aminotransferase; HBV Hepatitis B virus
Figure 2)
Figure 2)
Relative potencies of different hepatitis B antivirals at 48 to 52 weeks of therapy. Lamivudine has been compared with entecavir (105) and telbivudine (118) in two separate, randomized, controlled trials. Tenofovir was compared with adefovir followed by open-label tenofovir in separate, randomized, clinical trials. A Proportion of patients with hepatitis B virus (HBV) DNA <80 IU/mL. B Mean log10 IU/mL decline in HBV DNA levels. Anti-HBe Hepatitis B e antibody; HBeAg Hepatitis B e antigen
Figure 3)
Figure 3)
Rates of resistance to antiviral agents by duration of therapy
Figure 4)
Figure 4)
Suggested algorithms for management of patients with compensated hepatitis B cirrhosis. HBV Hepatitis B virus
See this image and copyright information in PMC

References

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