caa a22 4500 445797959 CHVBK 20180317145132.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s10620-011-1841-5 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1841-5 The Management of Chronic Hepatitis B in Asian Americans [Elektronische Daten] [Myron Tong, Calvin Pan, Hie-Won Hann, Kris Kowdley, Steven-Huy Han, Albert Min, Truong-Sinh Leduc] Hepatitis B virus (HBV) infection is common with major clinical consequences worldwide. In Asian Americans, the HBsAg carrier rate ranges from 7 to 16%; HBV is the most important cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). Patients are first diagnosed at different stages of clinical disease, which is categorized by biochemical and virologic tests. Patients at risk for liver complications should be identified and offered antiviral therapy. The two antiviral agents recommended for first-line treatment of chronic hepatitis B (CHB) are entecavir and tenofovir. The primary goal of therapy is sustained suppression of viral replication to achieve clinical remission, reverse fibrosis, and prevent and reduce progression to end-stage liver disease and HCC. Asian patients with chronic hepatitis, either HBeAg-positive or -negative, with HBV DNA levels >104copies/mL (>2,000IU/mL) and alanine aminotransferase (ALT) values above normal are candidates for antiviral therapy. HBeAg-negative patients with HBV DNA >104copies/mL (>2,000IU/mL) and normal ALT levels but who have either serum albumin ≤3.5g/dL or platelet count ≤130,000mm3, basal core promoter mutations, or who have first-degree relatives with HCC should be offered treatment. Patients with cirrhosis and detectable HBV DNA must receive antiviral therapy. Considerations for treatment include pregnant women with high viremia, coinfected patients, and those requiring immunosuppressive therapy. In HBsAg-positive patients with risk factors, lifelong surveillance for HCC with alpha-fetoprotein testing and abdominal ultrasound examination at 6-month intervals is required. These recommendations are based on a review of relevant literature and the opinion of a panel of Asian American physicians with expertise in hepatitis B treatment. Springer Science+Business Media, LLC, 2011 Hepatitis B nationallicence Clinical features nationallicence Antiviral therapy nationallicence HBV : Hepatitis B virus nationallicence HBsAg : Hepatitis B surface antigen nationallicence HBeAg : Hepatitis B e antigen nationallicence Anti-HBe : Antibody to HBeAg nationallicence Anti-HBs : Antibody to HBsAg nationallicence Anti-HBc : Antibody to hepatitis B core antigen nationallicence PC : Precore nationallicence BCP : Basal core promoter nationallicence HBV DNA : Hepatitis B virus DNA nationallicence CHB : Chronic hepatitis B nationallicence ALT : Alanine aminotransferase nationallicence HAI : Histology activity index nationallicence HIV : Human immunodeficiency virus nationallicence HCV : Hepatitis C virus nationallicence HDV : Hepatitis D virus nationallicence Tong Myron Pfleger Liver Institute, and the Division of Digestive Diseases, University of California School of Medicine, Los Angeles, CA, USA aut Pan Calvin Division of Liver Diseases, Mount Sinai School of Medicine, New York, NY, USA aut Hann Hie-Won Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA, USA aut Kowdley Kris Center for Liver Disease, Virginia Mason Medical Center, Seattle, WA, USA aut Han Steven-Huy Pfleger Liver Institute, and the Division of Digestive Diseases, University of California School of Medicine, Los Angeles, CA, USA aut Min Albert Division of Digestive Diseases, Beth Israel Medical Center, New York, NY, USA aut Leduc Truong-Sinh Leduc Medical Group, Fountain Valley, CA, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3143-3162 0163-2116 56:11<3143 2011 56 10620 https://doi.org/10.1007/s10620-011-1841-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1841-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tong Myron Pfleger Liver Institute, and the Division of Digestive Diseases, University of California School of Medicine, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Pan Calvin Division of Liver Diseases, Mount Sinai School of Medicine, New York, NY, USA aut NATIONALLICENCE 700 1- Hann Hie-Won Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Kowdley Kris Center for Liver Disease, Virginia Mason Medical Center, Seattle, WA, USA aut NATIONALLICENCE 700 1- Han Steven-Huy Pfleger Liver Institute, and the Division of Digestive Diseases, University of California School of Medicine, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Min Albert Division of Digestive Diseases, Beth Israel Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Leduc Truong-Sinh Leduc Medical Group, Fountain Valley, CA, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3143-3162 0163-2116 56:11<3143 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer