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HEPATITIS B – NEW DIAGNOSTIC ALGORITHMS, MONITORING TREATMENT AND DRUG RESISTANCE

Bowden, Scott

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Pathology - Journal of the RCPA: 2010 - Volume 42 - Issue - p S51
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Several recent advances have helped to redesign treatment algorithms for chronic hepatitis B. The recognition that there was a biological gradient of serum hepatitis B virus (HBV) DNA associated with an increased risk of liver disease has allowed more patients to be identified as candidates for antiviral therapy. The limited success of currently available therapy has prompted international liver societies to propose treatment guidelines. Unfortunately, treatment with nucleoside and nucleotide analogues has been compromised by the seemingly inevitable development of drug resistance. Drug resistance is of particular concern due to the increasing number of agents with potential for cross‐resistance, which emphasises the importance of sensitive assays for viral load and for defining genotypic resistance. Other promising markers for determining treatment eligibility and predicting response include HBV genotype and the measurement of intrahepatic HBV replicative forms. Most recently, data from clinical trials suggests a possible role for on‐treatment quantification of hepatitis B surface antigen during interferon‐based therapy in predicting virological outcome. At present, ongoing research is defining the clinical utility of these markers in the management of chronic hepatitis B.

© 2010 Royal College of Pathologists of Australasia