HBV trt extensions

1. Kurdistan Board GEH/GIT Surgery J Club 2022
Supervised by Professor Dr. Mohamed Alshekhani.

2. Introduction:
 CHBV infection is a major global health problem affecting 257 million
&resulting in 887,000 deaths.
 Only 10.5% chronically infected are aware of their infection&only 16.7%
of those who had been diagnosed were on treatment.
 The immediate goals of antiviral treatment are to suppress HBV
replication& decrease liver injury,whereas the long-term goals are to
prevent cirrhosis,HCC& liver-related mortality.
 Successful antiviral treatment can also prevent transmission to susceptible
persons&decrease stigma for those infected.
 Immune tolerance defined as the presence of HBeAg, with very high HBV
DNA usually >107 IU/ mL&normal ALT (<ULN).

7. Conclusion:
 All HBV guidelines emphasize that clinical management must take into
consideration individual patient characteristics, the importance of disease
monitoring& further evaluation/closer monitoring of patients in the grey
zone to identify those who require treatment.
 Available data support expanding treatment to immune tolerant&grey
zone patients who have evidence of active/advanced liver disease on liver
biopsy or noninvasive tests&immune tolerant patients >30-40 years old.
 These data do not support expanding treatment to true inactive carriers or
all immune tolerant patients ,unless safe, new therapies that can achieve
functional cure (HBsAg loss) in a high percentage of patients after a finite
course of treatment.