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Sinn: Natural History and Treatment Indications of Chronic Hepatitis B
Special Review
Diagnosis and Treatment of Chronic Hepatitis B: How Far Have We Come?

The Korean Journal of Gastroenterology 2019; 74(5): 245-250.

Published online: 27 November 2019

DOI: https://doi.org/10.4166/kjg.2019.74.5.245

Natural History and Treatment Indications of Chronic Hepatitis B

Dong Hyun Sinn

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Correspondence to: Dong Hyun Sinn, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel: +82-2-3410-3409, Fax: +82-2-3410-6983, dh.sinn@samsung.com

Received 12 October 2019       Revised 27 October 2019       Accepted 28 October 2019

Copyright © 2019. Korean Society of Gastroenterology

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

HBV is the most common etiology of both liver cirrhosis and hepatocellular carcinoma in Korea. Despite much progress made, the currently available antiviral therapies cannot eradicate or eliminate this virus. Hence, the benefits and risks of antiviral therapy should be carefully evaluated on an individual basis and within the context of the clinical situation. The ultimate goals of treatment are to decrease the mortality from liver disease. The benefits of antiviral therapy come from prevention of progression of liver disease. Understanding the natural history of chronic HBV infection is a key step in the decision making process to treat patients with chronic HBV infection. Generally, chronic hepatitis B patients in the immune tolerant phase and immune inactive phase are not recommended to undergo antiviral treatment, except for those patients in special conditions (e.g., immunosuppression or anticancer chemotherapy). Chronic hepatitis B patients in the immune active phase are recommended for antiviral therapy. For patients with liver cirrhosis, treatment should be considered when serum HBV DNA is detectable regardless of the serum level of ALT.

Keywords: Hepatitis B virus, Natural history, Treatment indication

Notes

Financial support None.

Conflict of interest None.

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Dong Hyun Sinn
https://orcid.org/0000-0002-7126-5554

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