More Patients With Chronic HBV Could Benefit From Antiviral Therapy

A wider range of patients with chronic hepatitis B virus (HBV) may benefit from antiviral treatment than current guidelines indicate, according to findings of a new review.

To date, patients with chronic HBV who have active liver disease or advanced fibrosis or cirrhosis have been the primary candidates for antiviral medication and have experienced improved outcomes. But because antiviral treatment does not eradicate the virus—and because most patients require long-term treatment to maintain clinical benefit—professional guidelines do not recommend such treatment for all patients with chronic HBV infection.

However, the review results show that existing data do indicate that immune-tolerant patients, patients with evidence of active or advanced liver disease (based on liver biopsy or noninvasive tests), and patients who remain in the immune-tolerant phase after 40 years of age may also experience improvement if given antiviral medications.

“HBV treatment indications can be more liberal when new therapies that can achieve HBsAg loss safely in a high percentage of patients after a finite course of treatment are available,” the researchers concluded.

—Rebecca Mashaw

Reference:

Jeng WJ, Lok AS. Should treatment indications for chronic hepatitis B be expanded? Clin Gastroenterol Hepatol. 2020;S1542-3565(20):30677. doi:10.1016/j.cgh.2020.04.091