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Journal Article•DOI•

Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance

Norah A. Terrault1, Anna S. Lok2, Brian J. McMahon, Kyong-Mi Chang3, Jessica P. Hwang4, Maureen M. Jonas, Robert S. Brown5, Natalie Bzowej6, John B. Wong7 •
University of California, San Francisco1, University of Michigan2, University of Pennsylvania3, University of Texas at Austin4, Cornell University5, Ochsner Medical Center6, Tufts University7
01 Apr 2018-Hepatology (John Wiley and Sons Ltd)-Vol. 67, Iss: 4, pp 1560-1599
TL;DR: This AASLD 2018 Hepatitis B Guidance provides a data-supported approach to screening, prevention, diagnosis, and clinical management of patients with hepatitis B.
About: This article is published in Hepatology.The article was published on 2018-04-01 and is currently open access. It has received 2399 citations till now. The article focuses on the topics: Hepatitis B & Mass screening.
Citations
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Journal Article•
Review of recent research on hepatitis C therapy for 54th annual meeting of the American association for the study of liver diseases

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Lai Wei1•
Peking University1
01 Feb 2004-Chinese Journal of Hepatology

2,135 citations

Management of hepatitis B: Summary of a clinical research workshop Potential conflict of interest: Dr. Lok is a consultant and received grants from GlaxoSmithKline, Bristol-Myers Squibb, Idenix, Gilead, Roche, and Innogenetics.

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Jay H. Hoofnagle, Edward Doo, T. Jake Liang, Russell Fleischer, Anna S.F. Lok 
01 Apr 2007
TL;DR: Several oral nucleoside analogues with activity against HBV have been shown to be effective in suppressing viral levels and improving biochemical and histological features of disease in a high proportion of patients with and without HBeAg, at least in the short term.
Abstract: Chronic hepatitis B is caused by persistent infection with the hepatitis B virus (HBV), a unique DNA virus that replicates through an RNA intermediate produced from a stable covalently closed circular DNA molecule. Viral persistence appears to be due to inadequate innate and adaptive immune responses. Chronic infection has a variable course after several decades resulting in cirrhosis in up to one‐third of patients and liver cancer in a proportion of those with cirrhosis. Sensitive assays for HBV DNA levels in serum have been developed that provide important insights into pathogenesis and natural history. Therapy of hepatitis B is evolving. Peginterferon induces long‐term remissions in disease in one‐third of patients with typical hepatitis B e antigen (HBeAg) positive chronic hepatitis B, but a lesser proportion of those without HBeAg. Several oral nucleoside analogues with activity against HBV have been shown to be effective in suppressing viral levels and improving biochemical and histological features of disease in a high proportion of patients with and without HBeAg, at least in the short term. What is uncertain is which agent or combination of agents is most effective, how long therapy should last, and which criteria should be used to start, continue, switch or stop therapy. Long‐term therapy with nucleoside analogues may be the most appropriate approach to treatment, but the expense and lack of data on long‐term safety and efficacy make recommendations difficult. Clearly, many basic and clinical research challenges remain in defining optimal means of management of chronic hepatitis B. (HEPATOLOGY 2007;45:1056–1075.)

568 citations

Journal Article•DOI•
Sexually Transmitted Infections Treatment Guidelines,2021

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Kimberly A. Workowski, Laura H. Bachmann, Philip A. Chan, Christine Johnston, Christina A. Muzny, Ina U. Park, Hilary Reno, Jonathan M. Zenilman, Gail Bolan 
23 Jul 2021
TL;DR: These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11-14, 2019.
Abstract: These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11-14, 2019. The information in this report updates the 2015 guidelines. These guidelines discuss 1) updated recommendations for treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; 2) addition of metronidazole to the recommended treatment regimen for pelvic inflammatory disease; 3) alternative treatment options for bacterial vaginosis; 4) management of Mycoplasma genitalium; 5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors for syphilis testing among pregnant women; 7) one-time testing for hepatitis C infection; 8) evaluation of men who have sex with men after sexual assault; and 9) two-step testing for serologic diagnosis of genital herpes simplex virus. Physicians and other health care providers can use these guidelines to assist in prevention and treatment of STIs.

544 citations

Journal Article•DOI•
Diagnosis and Management of Autoimmune Hepatitis in Adults and Children: 2019 Practice Guidance and Guidelines From the American Association for the Study of Liver Diseases.

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Cara L. Mack1, David H. Adams2, David N. Assis3, Nanda Kerkar4, Michael P. Manns5, M.J. Mayo6, John M. Vierling7, Mouaz Alsawas8, Mohammad Hassan Murad8, Albert J. Czaja8 •
University of Colorado Denver1, University of Birmingham2, Yale University3, University of Rochester Medical Center4, Hannover Medical School5, University of Texas at Austin6, Baylor College of Medicine7, Mayo Clinic8
01 Aug 2020-Hepatology
TL;DR: This practice guideline/guidance constitutes an update of the guidelines on AIH published in 2010 by the American Association for the Study of Liver Diseases (AASLD) and updates the epidemiology, diagnosis, management, and outcomes of AIH in adults and children.

402 citations

Cites background from "Update on prevention, diagnosis, an..."

  • ...Watchful monitoring with intent of on-demand therapy has been recommended for patients at low risk.(298,299) The risk of HBV reactivation in patients with AIH who are treated with conventional regimens of prednisone or prednisolone in combination with AZA is unknown....

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  • ...(298) Depending on the risk category, a preemptive treatment or monitoring strategy with the intent of ondemand therapy can be developed.(298,299) Prophylactic antiviral therapy, preferably with entecavir or tenofovir, during immunosuppressive treatment and for at least 6 months after treatment (or at least 12 months after treatment with anti-CD20 agents) has been recommended for individuals at high to moderate risk of HBV reactivation....

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  • ...Assessments of serum HBV DNA and HBsAg at intervals of 1-3 months has been suggested by the AASLD....

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  • ...Assessments of serum HBV DNA and HBsAg at intervals of 1-3 months has been suggested by the AASLD.(299) High-dose therapy or the institution of B cell–depleting agents, cytokine antagonists, calcineurin inhibitors, or other immune inhibitory agents may increase the risk of reverse seroconversion; and it is best avoided in these patients....

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  • ...Patients on immunosuppressive agents are at risk for reactivation of HBV infection, and guidelines have been developed recommending routine pretreatment screening of patients for hepatitis B surface antigen (HBsAg) and antibodies to hepatitis B core antigen (anti-HBc).(296-299) Based on the serological profile (HBsAg-positive versus HBsAg-negative/ anti-HBc-positive) and the type, dose, and duration of immunosuppressive therapy, the risk of HBV reactivation during treatment can be estimated as high (≥10%), moderate (1%-10%), and low (<1%)....

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Journal Article•DOI•
2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis

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Liana Fraenkel1, Joan M. Bathon2, Bryant R. England3, E. William St. Clair4, Thurayya Arayssi5, Kristine Carandang6, Kevin D. Deane7, Mark C. Genovese8, Kent Kwas Huston, Gail S. Kerr9, Joel M. Kremer10, Mary C. Nakamura11, Linda A. Russell12, Jasvinder A. Singh13, Benjamin J Smith14, Jeffrey A. Sparks15, Shilpa Venkatachalam, Michael E. Weinblatt15, Mounir Al-Gibbawi16, Joshua F. Baker17, Kamil E. Barbour18, Jennifer L. Barton19, Laura C. Cappelli20, Fatimah Chamseddine16, Michael D. George17, Sindhu R. Johnson21, Lara A Kahale16, Basil S. Karam16, Assem M. Khamis16, Iris Navarro-Millán5, Reza Mirza22, Pascale Schwab19, Namrata Singh23, Marat Turgunbaev24, Amy S. Turner24, Sally Yaacoub16, Elie A. Akl16 •
Yale University1, NewYork–Presbyterian Hospital2, University of Nebraska Medical Center3, Duke University4, Cornell University5, University of California, San Diego6, University of Colorado Boulder7, Stanford University8, Howard University9, Albany Medical College10, University of California, San Francisco11, Hospital for Special Surgery12, University of Alabama at Birmingham13, Florida State University14, Brigham and Women's Hospital15, American University of Beirut16, University of Pennsylvania17, Centers for Disease Control and Prevention18, Oregon Health & Science University19, Johns Hopkins University20, Toronto Western Hospital21, University of Toronto22, University of Washington23, American College of Rheumatology24
01 Jul 2021-Arthritis Care and Research
TL;DR: In this article, the authors developed clinically relevant population, intervention, comparator, and outcomes (PICO) questions to develop updated guidelines for the pharmacologic management of rheumatoid arthritis.
Abstract: Objective To develop updated guidelines for the pharmacologic management of rheumatoid arthritis. Methods We developed clinically relevant population, intervention, comparator, and outcomes (PICO) questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the certainty of evidence. A voting panel comprising clinicians and patients achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. Results The guideline addresses treatment with disease-modifying antirheumatic drugs (DMARDs), including conventional synthetic DMARDs, biologic DMARDs, and targeted synthetic DMARDs, use of glucocorticoids, and use of DMARDs in certain high-risk populations (i.e., those with liver disease, heart failure, lymphoproliferative disorders, previous serious infections, and nontuberculous mycobacterial lung disease). The guideline includes 44 recommendations (7 strong and 37 conditional). Conclusion This clinical practice guideline is intended to serve as a tool to support clinician and patient decision-making. Recommendations are not prescriptive, and individual treatment decisions should be made through a shared decision-making process based on patients' values, goals, preferences, and comorbidities.

336 citations

References
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Management of hepatocellular carcinoma.

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Jordi Bruix1, Morris Sherman2•
University of Barcelona1, University Health Network2
01 Nov 2005-Hepatology
TL;DR: The prevention of Cirrhosis can prevent the development of HCC and progression from chronic HCV infection to advanced fibrosis or cirrhosis may be prevented in 40% of patients who are sustained responders to new antiviral strategies, such as pegylated interferon and ribavirin.

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Journal Article•DOI•
AASLD guidelines for the treatment of hepatocellular carcinoma

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Julie K. Heimbach1, Laura Kulik2, Richard S. Finn3, Claude B. Sirlin4, Michael Abecassis2, Lewis R. Roberts1, Andrew X. Zhu5, M. Hassan Murad1, Jorge A. Marrero6 •
Mayo Clinic1, Northwestern University2, University of California, Los Angeles3, University of California, San Diego4, Harvard University5, University of Texas Southwestern Medical Center6
01 Jan 2018-Hepatology
TL;DR: This paper aims to demonstrate the efforts towards in-situ applicability of EMMARM, as to provide real-time information about concrete mechanical properties such as E-modulus and compressive strength.

2,734 citations

"Update on prevention, diagnosis, an..." refers methods in this paper

  • ...The AASLD 2018 Practice Guidelines on HCC has been published.((133)) Of the 2 tests prospectively evaluated as screening tools for HCC, alphafetoprotein (AFP) and ultrasonography (US), the sensitivity, specificity, and diagnostic accuracy of US are higher than those of AFP....

    [...]

Journal Article•DOI•
Chronic hepatitis B: Update 2009

[...]

Anna S.F. Lok1, Brian J. McMahon2•
University of Michigan1, Alaska Native Medical Center2
01 Sep 2009-Hepatology
TL;DR: The 2009 update of the American Association for the Study of Liver Diseases (AASLD) Practice Guidelines for Management of Chronic Hepatitis B is now posted online at www.aasld.org, and the recommendation for first-line oral antiviral medications has been changed to tenofovir or entecavir, and adefovir has been moved to second-line Oral antiviral medication.

2,696 citations

"Update on prevention, diagnosis, an..." refers background in this paper

  • ...Anti-HBc may be the only marker of HBV infection during the window phase of acute hepatitis B; these persons should test positive for antiHBc immunoglobulin M.((37,38)) iv....

    [...]

  • ...Some persons may test positive for anti-HBc, but not HBsAg; they may or may not also have anti-HBs, with the prevalence depending on local endemicity or the risk group.((37,38)) The finding of isolated anti-HBc (anti-HBc positive but negative for HBsAg and antiHBs) can occur for a variety of reasons....

    [...]

Journal Article•DOI•
Management of hepatocellular carcinoma.

[...]

K.E.F. Hobbs1, Geoffrey Dusheiko1•
Royal Free Hospital1
01 Jul 1992-Journal of Hepatology

2,558 citations

"Update on prevention, diagnosis, an..." refers background in this paper

  • ...2% per year.((134)) Using this principle, all patients with cirrhosis warrant screening....

    [...]

  • ...For patients without cirrhosis, age, sex, race, and family history determine when surveillance should begin.((134,135)) Other subgroups with a higher risk of HCC include persons with HCV, HDV, or HIV coinfections and those with fatty liver....

    [...]

Journal Article•DOI•
Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures

[...]

Daniel Lavanchy1•
World Health Organization1
01 Mar 2004-Journal of Viral Hepatitis
TL;DR: More efficacious treatments, mass immunization programs, and safe injection techniques are essential for eliminating HBV infection and reducing global HBV‐related morbidity and mortality.
Abstract: Hepatitis B virus (HBV) infection is a serious global health problem, with 2 billion people infected worldwide, and 350 million suffering from chronic HBV infection. The 10th leading cause of death worldwide, HBV infections result in 500 000 to 1.2 million deaths per year caused by chronic hepatitis, cirrhosis, and hepatocellular carcinoma; the last accounts for 320 000 deaths per year. In Western countries, the disease is relatively rare and acquired primarily in adulthood, whereas in Asia and most of Africa, chronic HBV infection is common and usually acquired perinatally or in childhood. More efficacious treatments, mass immunization programs, and safe injection techniques are essential for eliminating HBV infection and reducing global HBV-related morbidity and mortality. Safe and effective vaccines against HBV infection have been available since 1982. The implementation of mass immunization programs, which have been recommended by the World Health Organization since 1991, have dramatically decreased the incidence of HBV infection among infants, children, and adolescents in many countries. However, not all countries have adopted these recommendations and there remains a large number of persons that were infected with HBV prior to the implementation of immunization programs. Antiviral treatment is the only way to reduce morbidity and mortality from chronic HBV infection. Conventional interferon alfa and lamivudine have been the primary treatments to date. Conventional interferon alfa produces a durable response in a moderate proportion of patients but has undesirable side-effects and must be administered subcutaneously three times per week. Lamivudine also produces a response in a modest proportion of patients and causes few side-effects. However, prolonged treatment is often necessary to prevent relapse on cessation of therapy, and continuous treatment can lead to the development of lamivudine resistance. Promising emerging new treatments include adefovir, entecavir and peginterferon alfa-2a (40 kDa).

2,552 citations

"Update on prevention, diagnosis, an..." refers background in this paper

  • ...The prevalence of HBsAg varies greatly across countries, with high prevalence of HBsAg-positive persons defined as 8%, intermediate as 2% to 7%, and low as <2%.((21,22)) In developed countries, the prevalence is higher among those who immigrated from high- or intermediate-prevalence countries and in those with high-risk behaviors....

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EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection.

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Pietro Lampertico, Kosh Agarwal, Thomas Berg, Maria Buti, Harry L.A. Janssen, George V. Papatheodoridis, Fabien Zoulim, Frank Tacke 
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Aparna Schweitzer, Johannes Horn, Rafael T. Mikolajczyk, Gérard Krause, Jördis J Ott 
Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study

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Devin Razavi-Shearer, Ivane Gamkrelidze, Mindie H. Nguyen  +193 more