RSS Feeds
National Institutes of Health Consensus Development Conference Statement: Management of Hepatitis B
- Michael F. Sorrell, MD;
- Edward A. Belongia, MD;
- Jose Costa, MD;
- Ilana F. Gareen, PhD;
- Jean L. Grem, MD;
- John M. Inadomi, MD;
- Earl R. Kern, PhD;
- James A. McHugh, MD;
- Gloria M. Petersen, PhD;
- Michael F. Rein, MD;
- Doris B. Strader, MD; and
- Hartwell T. Trotter, MS*
- From the University of Nebraska Medical Center, Omaha, Nebraska; Marshfield Clinic Research Foundation, Marshfield, Wisconsin; Yale University School of Medicine, New Haven, Connecticut; Brown University, Providence, Rhode Island; University of California, San Francisco, and San Francisco General Hospital, San Francisco, California; The University of Alabama School of Medicine, Birmingham, Alabama; University of Washington School of Medicine and Swedish Physicians—Central Seattle Clinic, Seattle, Washington; Mayo Clinic, Rochester, Minnesota; University of Virginia, Charlottesville, Virginia; University of Vermont College of Medicine, Burlington, Vermont; and American Melanoma Foundation, San Diego, California.
National Institutes of Health (NIH) consensus and state-of-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of 1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ); 2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session; 3) questions and statements from conference attendees during open discussion periods that are part of the public session; and 4) closed deliberations by the panel during the remainder of the second day and morning of the third. This statement is an independent report of the panel and is not a policy statement of the National Institutes of Health or the U.S. government. The statement reflects the panel's assessment of medical knowledge available at the time the statement was written. Thus, it provides a “snapshot in time” of the state of knowledge on the conference topic. When reading the statement, keep in mind that new knowledge is inevitably accumulating through medical research.
Hepatitis B is a major cause of liver disease worldwide, ranking as a substantial cause of cirrhosis and hepatocellular carcinoma. The development and use of a vaccine for hepatitis B virus (HBV) has resulted in a substantial decline in the number of new cases of acute hepatitis B among children, adolescents, and adults in the United States. However, this success has not yet been duplicated worldwide, and both acute and chronic HBV infection continue to represent important global health problems.
Seven treatments are currently approved for adult patients with chronic HBV infection in the United States: interferon-α, pegylated interferon-α, lamivudine, adefovir dipivoxil, entecavir, telbivudine, and tenofovir disoproxil fumarate. Interferon-α and lamivudine have been approved for children with HBV infection. Although available randomized, controlled trials (RCTs) show encouraging short-term …
