Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2021; 27(43): 7497-7508
Published online Nov 21, 2021. doi: 10.3748/wjg.v27.i43.7497
Hepatitis B: Who should be treated?-managing patients with chronic hepatitis B during the immune-tolerant and immunoactive phases
Miwa Kawanaka, Ken Nishino, Hirofumi Kawamoto, Ken Haruma
Miwa Kawanaka, Ken Nishino, Hirofumi Kawamoto, Ken Haruma, Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Okayama 700-8505, Japan
Author contributions: Kawanaka M conceived, planned, performed, and supervised the methodology, as well as analyzed the data, interpreted the results, created graphics, wrote, and reviewed the manuscript; Nishino K acquired the funding for the study; Haruma K and Kawamoto H administered the project; all authors provided critical feedback and helped shape the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interest regarding publication of this manuscript.
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: Miwa Kawanaka, MD, PhD, Associate Professor, Doctor, Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, 2-6-1 Nakasange, Kita-ku, Okayama 700-8505, Japan.
Received: April 23, 2021
Peer-review started: April 23, 2021
First decision: June 13, 2021
Revised: July 31, 2021
Accepted: October 31, 2021
Article in press: October 31, 2021
Published online: November 21, 2021
Core Tip

Core Tip: Hepatitis B virus (HBV) is a global health problem that causes acute and chronic infections and often leads to liver cirrhosis and hepatocellular carcinoma. Treatment of HBV is recommended for patients in the immunoactive hepatitis B surface-antigen-positive and -negative phases. Follow-up is recommended only for patients in the immune-inactive phase and the immune-tolerant phase, but opinion on this recommendation remain divided. This review discusses the major international guidelines for the treatment of chronic hepatitis B and highlights the importance of clinical factors for making decisions regarding the management of patients with HBV infection.