No abstract available.

No abstract available.

No abstract available.
Diagnosis* ; Hepatitis B, Chronic* ; Hepatitis, Chronic*

No abstract available.
Diagnosis* ; Hepatitis B, Chronic* ; Hepatitis, Chronic*

Chronic hepatitis B (CHB) is a serious health problem in Korea. The natural history of chronic HBV infection has been divided into 4 phases: immune tolerance, immune clearance, inactive HBsAg carrier state and reactivation. During the phases of immune tolerance and inactive HBsAg carrier state, no treatment is required. Patients in the immune clearance or reactivation phases are candidates for therapy. In the last years, treatment effects of CHB have considerably improved. Several agents are currently approved for the treatment of CHB: interferon alpha, pegylated interferon alpha, lamivudine, adefovir, entecavir, telbivudine and clevudine in Korea. The treatment recommendations from the 2004 Korean Association for the Study of the Liver guideline on the management of CHB have been updated to incorporate new therapeutic options. What is uncertain is which agent or combination of agents is most effective, how long therapy should last, and which criteria should be used to start, continue, switch or stop therapy. Issues for consideration include efficacy, safety and incidences of resistance, and method of administration of antiviral therapy in treatment-naive patients.
Adenine/analogs & derivatives/therapeutic use ; Antiviral Agents/*therapeutic use ; Arabinofuranosyluracil/analogs & derivatives/therapeutic use ; Guanine/analogs & derivatives/therapeutic use ; Hepatitis B, Chronic/*drug therapy ; Humans ; Interferon Alfa-2a/therapeutic use ; Interferon Alfa-2b/therapeutic use ; Korea ; Lamivudine/therapeutic use ; Phosphonic Acids/therapeutic use ; Polyethylene Glycols/therapeutic use ; Practice Guidelines as Topic

Progressive hepatic fibrosis with development of cirrosis is a feature of chronic liver disease. Assessing fibrosis is important for predicting disease progression and patient management. Liver biopsy is the current gold standard for the diagnosis of liver fibrosis. However, liver biopsy is an invasive procedure. Alternative non-invasive methods have been developed. Serum markers are useful in predicting liver cirrhosis, but accuracy of serum markers is not satisfactory in the assessment of fibrosis. Newly developed transient elastography (Fibroscan) is a non-invasive method of measuring liver stiffness. Fibroscan has been reported to be superior in early detection of cirrhosis to serum markers. Factors influencing it's performance are not fully investigated. The evaluation of new tests should be continued to perform.
Biological Markers/blood ; Chronic Disease ; Disease Progression ; Elasticity Imaging Techniques/methods ; Fibrosis ; Humans ; Hyaluronic Acid/analysis ; Liver/*pathology ; Liver Cirrhosis/*diagnosis/etiology

No abstract available.
Carcinoma, Hepatocellular/*diagnosis ; Female ; Humans ; Liver Neoplasms/*diagnosis ; Male ; Non-alcoholic Fatty Liver Disease/*diagnosis

Cirrhotic patients have bleeding tendencies due to the lack of coagulation factors and thrombocytopenia. However, decreased levels of procoagulants are also accompanied by decreased levels of natural anticoagulants. However, there have been contrasting reports. It has been reported that patients with cirrhosis are at risk for thrombotic complications, including portal vein thrombosis and venous thromboembolism. Physicians consider active anticoagulation for prophylaxis and treatment of portal vein thrombosis and/or venous thromboembolism in cirrhotic patients with high risk of thrombosis. Concurrently, there are safety concerns regarding the risk of bleeding from anticoagulants in people with advanced liver disease. Further prospective studies are required to determine not only if cirrhotic patients benefit from receiving anticoagulation therapy for preventing thrombotic complications, but also to determine which prophylactic regimen is most appropriate.
Anticoagulants ; Blood Coagulation Factors ; Fibrosis ; Hemorrhage ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Prospective Studies ; Thrombocytopenia ; Thrombosis ; Venous Thromboembolism ; Venous Thrombosis

Although the prevalence of chronic hepatitis B has decreased considerably in recent years due to widespread use of the hepatitis B virus (HBV) vaccine, its prevalence still remains high in adults, and this can place a significant burden on health care in areas with endemic HBV. Since the introduction of nucleos(t)ide analogues (NUCs), there has been marked improvement in the care of patients with chronic hepatitis B, resulting in increased survival. However, the emergence of drug resistance in patients treated with NUCs is a major concern. The number of multi-drug resistant patients is increasing, and many patients may not respond to the currently available drugs. In this review, we describe the current status of NUC therapy for antiviral-naive and -resistant patients.
Adult ; Delivery of Health Care ; Drug Resistance ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Ophthalmoplegia ; Prevalence