Chronic hepatitis B (CHB) remains a major global healthcare challenge with changing epidemiology and increasing morbidity and mortality from the complications of liver cirrhosis and hepatocellular carcinoma (HCC). Hepatitis B virus infection can be broadly categorized into four disease phases: (1) hepatitis B e antigen (HBeAg)-positive chronic infection; (2) HBeAg-positive chronic hepatitis; (3) HBeAg-negative chronic infection; and (4) HBeAg-negative chronic hepatitis.
After hepatitis B surface antigen loss, patients do not require any specific follow-up but they carry a risk of reactivation in the event of immunosuppression. The primary treatment goal in CHB is to improve survival and quality of life by preventing disease progression and the development of HCC. Current treatment regimens are non-curative and, once initiated, treatment is usually of indefinite duration.
Treatment decisions are made on the basis of disease assessment and risk stratification. All CHB patients, including those on treatment, should be monitored for disease progression and HCC development. Hepatitis B virus/D virus co-infection represents the most severe form of chronic viral hepatitis because of more rapid disease progression and increased risk of cirrhosis and HCC; thus it requires special consideration. In the present review, we summarize the guidance on hepatitis B and D diagnosis and treatment.
Chronic hepatitis Bhepatitis B virus infectionhepatitis D virus infection