Affiliations 

  • 1 Department of Medicine, The University of Hong Kong Queen Mary Hospital, Hong Kong Special Administrative Region, China; Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China; State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong Special Administrative Region, China
  • 2 WHO Representative Office in Malaysia, Brunei Darussalam, and Singapore, Cyberjaya, Malaysia
  • 3 National Reference Centre for Viral Hepatitis B, C, and Delta, Department of Virology, Henri Mondor Hospital, University of Paris-Est, Créteil, France; Department of Molecular Virology and Immunology, Inserm U955, Créteil, France
  • 4 Department of Medicine, The University of Hong Kong Queen Mary Hospital, Hong Kong Special Administrative Region, China; Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China; State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong Special Administrative Region, China. Electronic address: mfyuen@hkucc.hku.hk
Lancet, 2018 11 24;392(10161):2313-2324.
PMID: 30496122 DOI: 10.1016/S0140-6736(18)31865-8

Abstract

Chronic hepatitis B virus infection is a global public health threat that causes considerable liver-related morbidity and mortality. It is acquired at birth or later via person-to-person transmission. Vaccination effectively prevents infection and chronic hepatitis B virus carriage. In chronically infected patients, an elevated serum hepatitis B virus DNA concentration is the main risk factor for disease progression, although there are other clinical and viral parameters that influence disease outcomes. In addition to liver biochemistry, virological markers, and abdominal ultrasonography, non-invasive assessment of liver fibrosis is emerging as an important assessment modality. Long-term nucleos(t)ide-analogue therapy is safe and well tolerated, achieves potent viral suppression, and reduces the incidence of liver-related complications. However, a need to optimise management remains. Promising novel therapies are at the developmental stage. With current vaccines, therapies, and an emphasis on improving linkage to care, WHO's goal of eliminating hepatitis B virus as a global health threat by 2030 is achievable.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.