Treatment of HBV-related cirrhosis

Abstract

The goal of antiviral therapy in HBV cirrhotic patients is to prevent progression of the disease to decompensated cirrhosis, end-stage liver disease, hepatocellular carcinoma and death. This goal can be achieved if HBV replication can be suppressed, leading to biochemical remission, histological improvement and prevention of complications. If finite treatment with pegylated interferon is not contraindicated in compensated cirrhosis, long-term treatment with nucleoside/nucleotide analogues is recommended in patients with HBV-related cirrhosis, especially in decompensated cirrhosis. Patients with cirrhosis require careful monitoring to detect resistance and prevent flares, and also to screen for hepatocellular carcinoma, portal hypertension and liver failure.

Keywords::

• cirrhosis
• HBV
• hepatitis B virus
• hepatocellular carcinoma
• nucleoside and nucleotide analogues

Financial & competing interests disclosure

Vincent Mallet: Schering-Plough, Bristol-Myers Squibb and Gilead; Anais Vallet-Pichard: Schering-Plough, Bristol-Myers Squibb, Gilead and Roche; Charlotte E Costentin: Novartis; Stanislas Pol is a Board member/speaker for Schering-Plough, Bristol-Myers Squibb, Gilead, Roche, Boerhinger Ingelheim, Wyeth, GlaxoSmithKline and Tibotec. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.