The expert consensus on clinical cure (functional cure) of chronic hepatitis B.
10.3760/cma.j.issn.1007-3418.2019.08.003
- VernacularTitle:慢性乙型肝炎临床治愈(功能性治愈)专家共识
- Collective Name:Chinese Society of Infectious Disease Chinese Society of Hepatology;Chinese Medical Association
- Publication Type:Journal Article
- Keywords:
Clinical cure;
Combination therapy;
Consensus;
Functional cure;
HBsAg loss;
Hepatitis B
- MeSH:
Antiviral Agents/therapeutic use*;
Consensus;
DNA, Viral/blood*;
Hepatitis B Surface Antigens/blood*;
Hepatitis B e Antigens/blood*;
Hepatitis B virus;
Hepatitis B, Chronic/therapy*;
Humans;
Practice Guidelines as Topic;
Randomized Controlled Trials as Topic
- From:
Chinese Journal of Hepatology
2019;27(8):594-603
- CountryChina
- Language:Chinese
-
Abstract:
Chronic hepatitis B virus (HBV) infection remains a major world public health problem. Current guidelines for the prevention and treatment of chronic hepatitis B (CHB) have suggested clinical cure (also known as functional cure) as the ideal therapeutic goal, which is associated with decreased risk of cirrhosis and hepatocellular carcinoma. Clinical cure is defined as sustained, undetectable serum HBsAg, HBeAg and HBV DNA with or without seroconversion to anti-HBs, but with the persistence of residual cccDNA, accompanied by resolution of liver injury after the completion of a finite course of treatment. Accumulating data from a series of randomized controlled trials as well as clinical practice have confirmed certain clinical benefit of optimal sequential/ combination strategies of direct acting antiviral drugs (DAA) [such as nucleoside analogues (NA)] or immunomodulators (such as pegylated interferon alpha (Peg-IFN)] for appropriately selected CHB patients. This consensus provides an updated and comprehensive analysis of the data supporting the use of combination therapies and summarizes the roadmap towards clinical cure of CHB to guide decision-making in clinical practice.
