Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11595
Revised: January 3, 2014
Accepted: April 27, 2014
Published online: September 7, 2014
This review analyzes progress and limitations of diagnosis, screening, and therapy of patients with chronic hepatitis B infection. A literature review was carried out by framing the study questions. Vaccination in early childhood has been introduced in most countries and reduces the infection rate. Treatment of chronic hepatitis B can control viral replication in most patients today. It reduces risks for progression and may reverse liver fibrosis. The treatment effect on development of hepatocellular carcinoma is less pronounced when cirrhosis is already present. Despite the success of vaccination and therapy chronic hepatitis B remains a problem since many infected patients do not know of their disease. Although all guidelines recommend screening in high risk groups such as migrants, these suggestions have not been implemented. In addition, the performance of hepatocellular cancer surveillance under real-life conditions is poor. The majority of people with chronic hepatitis B live in resource-constrained settings where effective drugs are not available. Despite the success of vaccination and therapy chronic hepatitis B infection remains a major problem since many patients do not know of their disease. The problems in diagnosis and screening may be overcome by raising awareness, promoting partnerships, and mobilizing resources.
Core tip: This review analyzes progress and limitations of diagnosis, screening, and therapy of patients with chronic hepatitis B. Treatment can control viral replication in most patients today. It reduces risks for progression and may reverse fibrosis. However, screening recommendations have not been implemented, and the performance of hepatocellular carcinoma surveillance is poor. Many patients with chronic hepatitis B live in resource-constrained settings where effective drugs are not available. Despite the therapeutic progress, chronic hepatitis B remains a problem since many patients do not know of their disease. These problems may be overcome by raising awareness, promoting partnerships, and mobilizing resources.