Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2021; 27(40): 6861-6873
Published online Oct 28, 2021. doi: 10.3748/wjg.v27.i40.6861
Management of hepatitis B and C in special population
Anand V Kulkarni, Nageshwar Reddy Duvvuru
Anand V Kulkarni, Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad 500032, Telangana, India
Nageshwar Reddy Duvvuru, Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad 500032, Telanagana, India
Author contributions: Kulkarni AV and Duvvuru NR made the study concept; Kulkarni AV did the initial drafting and DNR critically assessed and edited the manuscript; all authors approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Anand V Kulkarni, MD, Consultant Physician-Scientist, Department of Hepatology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad 500032, Telangana, India.
Received: February 22, 2021
Peer-review started: February 22, 2021
First decision: May 13, 2021
Revised: May 30, 2021
Accepted: September 14, 2021
Article in press: September 14, 2021
Published online: October 28, 2021

Chronic viral hepatitis is one of the leading causes of cirrhosis worldwide. Chronic hepatitis B is more common in the Asia-Pacific region due to the larger population and lower screening availability. Hepatitis C predominates in the west due to injection drug abuse. The discovery of (oral) direct-acting antiviral agents (DAAs) has changed the landscape of chronic hepatitis C (CHC) management. Nucleos(t)ide analogs (NUCs) have also changed the approach to the treatment of chronic hepatitis B (CHB). Oral NUCs and DAAs have excellent efficacy and patient acceptance as well as a lower risk of resistance. However, certain populations have no robust data and safety and efficacy of such oral drugs is still evolving. In this review, we provide an overview of the management of CHB and CHC in special populations, such as those with chronic kidney disease, pregnant women, healthcare workers, and those undergoing chemo- or immunosuppressive therapy.

Keywords: Chronic kidney disease, Pregnancy, Hepatitis B, Hepatitis C, Health care professionals, Tenofovir

Core Tip: Hepatitis B and hepatitis C are leading causes of liver disease and pose significant burdens on healthcare and the economy, especially in developing countries. The management of chronic hepatitis B and C in special populations is less known. In this review, we discuss the indications, timing of treatment, and safety of drugs in special populations infected with hepatitis B or C. The special populations discussed herein are those with chronic kidney disease, pregnant women, coinfected patients, healthcare workers, and patients undergoing chemotherapy.