Management of chronic hepatitis B in special populations

Abstract

Hepatitis B infection is an internationalhealthcare problem, particularly in developing areas.The hepatitis B virus (HBV) is frequently transmittedvia body fluids such as blood, semen, and vaginalsecretions. The majority of adults infected with thevirus recover, however 5%-10% are not capable toclear the virus and become chronically infected. Theprincipal treatment goals for patients with hepatitisB infection are to prevent progression of the liverdisease to cirrhosis or hepatocellular carcinoma. Theeffective nucleos(t)ide analogs (NAs) against hepatitisB virus (HBV) has improved the outcome ofpatients with chronic hepatitis B (CHB). Specialpopulations infected with chronic HBV includethose with decompensated cirrhosis, organ transplantation,pregnancy, extrahepatic manifestations,immunosuppressive-chemotherapy, co-infections(HIV-HCV- HDV), renal failure, hepatitis B virusinfection in children/adolescents and dental practice.These populations vary in their natural history andrisk of liver-related complications, the indicationsfor anti-HBV treatment in addition to the recommendationsconcerning the HBV drugs used, timeof therapy and expected endpoints. The aim ofthis review is to summarize the information on therelevance and treatment of HBV infection in suchspecial populations.