Via practica S3/2009

Treatment algorithm for chronic hepatitis B according to the 2009 EASL guidelines

In this review, the authors propose a new treatment algorithm for the management of chronic hepatitis B virus infection according to the 2009 EASL (European Association for the Study of the Liver) Clinical Practice Guidelines for diagnosis, monitoring and treatment of chronic HBV infection, published in February 2009. These guidelines originally published in 2002 have been updated on enhanced understanding of the natural history of HBV infection and the licensure of several new drugs including peginterferon alfa-2a and three new oral nucleos(t)ides (entecavir, telbivudine and tenofovir). The update to the original consensus statement includes revised definition of endpoints and response to therapy, a brief synopsis of the efficacy of currently approved therapies, strategies for treatment and management of treatment failure as well as on-treatment monitoring. The guidelines also include new recommendations for the management of pregnant women, children, healthcare workers and individuals co-infected with the hepatitis C virus and HIV. In addition, important differences are discussed between original 2002 EASL guidelines and recent guidelines developed by the AASLD (American Association for the Study of Liver Diseases), the APASL (Asian Pacific Association for the Study of the Liver) and the U.S. panel of nationally recognized liver specialists.

Keywords: hepatitis B, therapy, guidelines.