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Practice Guideline
. 2022 Apr;28(2):276-331.
doi: 10.3350/cmh.2022.0084. Epub 2022 Apr 1.

KASL clinical practice guidelines for management of chronic hepatitis B

Korean Association for the Study of the Liver (KASL)
Practice Guideline

KASL clinical practice guidelines for management of chronic hepatitis B

Korean Association for the Study of the Liver (KASL). Clin Mol Hepatol. 2022 Apr.

Erratum in

No abstract available

Keywords: Chronic hepatitis B; Disease management; KASL guidelines; Therapeutics; Treatment.

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Conflict of interest statement

Conflicts of Interest

Jang JW: Received honoraria from Gilead, Abbvie, Bayer, Roche, Sysmex, Ipsen. Received grants from Sysmex, Gilead, Yuhan, Dong-A ST, Hanmi

Park JY: Received grants from Gilead, Pfizer, MSD, BMS, Roche, Astrazeneca, Aramchol, Novonorodisk, Yuhan, Hanmi

Kwon JH: Received honoraria and grants from Gilead, Abbvie

Yu SJ: Received honoraria and grants from Gilead, Abbvie, BMS, Daewoong, Yuhan, Chongkundang Pharm, Dong-A ST, Samil, Samjin

Kang W: Received honoraria and grants from Gilead, BMS, Abbvie, Eisai, Bayer, Roche, MSD, Yuhan, Dong-A ST, Ildong, Daewoong, Samil, Boryung

Chon YE: Received honoraria from BMS, Dong-A ST, Abbvie, Daewoong

Kim TH: Nothing to declare

Choi J: Received honoraria from Gilead, Abbvie, Daewoong

An J: Received honoraria from Yuhan

Figures

Figure 1.
Figure 1.
Natural course of chronic hepatitis B (CHB). HBV, hepatitis B virus; HBsAg, hepatitis B surface antigen; anti-HBs, antibody to HBsAg; HBeAg, hepatitis B e antigen; anti-HBe, antibody to HBeAg; ALT, alanine aminotransferase.
Figure 2.
Figure 2.
Emerging markers for chronic hepatitis B infection. rcDNA, relaxed circular DNA; pgRNA, pregenomic RNA; p22Cr, p22 core-related antigen; HBcAg, hepatitis B core antigen; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HBcrAg, hepatitis B core-related antigen; dslDNA, double stranded linear DNA; cccDNA, circular covalently closed DNA; HBV, hepatitis B virus.
Figure 3.
Figure 3.
Algorithm for management of chronic hepatitis B virus infection. HBsAg, hepatitis B surface antigen; HBeAg, hepatitis B e antigen; HBV, hepatitis B virus; AST, aspartate aminotransferase; ALT, alanine aminotransferase; anti-HBe, hepatitis B e antibody. *Serum HBV DNA ≥107 IU/mL. †An upper limit of normal (ULN) for ALT of 34 IU/L for males and 30 IU/L for females. ‡Serum HBV DNA ≥20,000 IU/mL for HBeAg-positive patients and HBV DNA ≥2,000 IU/mL for HBeAg-negative patients.
Figure 4.
Figure 4.
The mechanisms of novel antiviral agents for the functional cure. NK, natural killer; TLR, toll-like receptor; ICI, immune checkpoint inhibitor; HBV, hepatitis B virus; NTCP, sodium taurocholate co-transporting polypeptide; SVP, subviral particle; HBsAg, hepatitis B surface antigen; HBeAg, hepatitis B e antigen; HBc, hepatitis B core; HBx, hepatitis B virus X protein; cccDNA, covalently closed circular DNA; ASO, antisense oligonucleotide; siRNA, small interfering RNA.
Figure 5.
Figure 5.
Indications for selecting entecavir, tenofovir alafenamide fumarate, or besifovir over tenofovir disoproxil fumarate. AF, alafenamide fumarate. *Dose was adjusted if creatinine clearance <50 mL/min, refer to Table 8. †Not indicated if creatinine clearance <15 mL/min without dialysis. ‡Not indicated if creatinine clearance <15 mL/min.
Figure 6.
Figure 6.
Strategies after liver transplantation in patients receiving anti-HBc-positive liver graft. Anti-HBc, antibody to HBcAg; HBsAg, hepatitis B surface antigen; NA, nucleos(t)ide analogue; HBIG, hepatitis B immunoglobulin; anti-HBs, antibody to HBsAg; HBV, hepatitis B virus. *Pooled data from the study by Cholongitas et al [431].
See this image and copyright information in PMC

References

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    1. Lee HA, Lee HW, Kim IH, Park SY, Sinn DH, Yu JH, et al. Extremely low risk of hepatocellular carcinoma development in patients with chronic hepatitis B in immune-tolerant phase. Aliment Pharmacol Ther. 2020;52:196–204. - PubMed

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