Treatment of chronic hepatitis B virus infection in resource-constrained settings: expert panel consensus.

Steven T. Wiersma, Brian McMahon, Jean Michel Pawlotsky, Chloe L. Thio, Mark Thursz, Seng Gee Lim, Ponsiano Ocama, Gamal Esmat, Mendy Maimuna, David Bell, Marco Vitoria, Irina Eramova, Daniel Lavanchy, Geoff Dusheiko, Health Organization Department of Immunization, Vaccines World Health Organization Department of Immunization, Vaccines

Research output: Contribution to journalReview articlepeer-review

52 Scopus citations


Most of the estimated 350 million people with chronic hepatitis B virus (HBV) infection live in resource-constrained settings. Up to 25% of those persons will die prematurely of hepatocellular carcinoma (HCC) or cirrhosis. Universal hepatitis B immunization programmes that target infants will have an impact on HBV-related deaths several decades after their introduction. Antiviral agents active against HBV are available; treatment of HBV infection in those who need it has been shown to reduce the risk of HCC and death. It is estimated that 20-30% of persons with HBV infection could benefit from treatment. However, drugs active against HBV are not widely available or utilized in persons infected with HBV. Currently recommended antiviral agents used for treatment of human immunodeficiency virus (HIV) infection do not adequately suppress HBV, which is of great concern for the estimated 10% of the HIV-infected persons in Africa who are co-infected with HBV. Progressive liver disease has been shown to occur in co-infected persons whose HBV infection is not suppressed. In view of these concerns, an informal World Health Organization consultation of experts concluded that: chronic HBV is a major public health problem in emerging nations; all HIV-infected persons should be screened for HBV infection; HIV/HBV co-infected persons should be treated with therapies active against both viruses and that reduce the risk of resistance; standards for the management of chronic HBV infection should be adapted to resource-constrained settings. In addition, a research agendum was developed focusing on issues related to prevention and treatment of chronic HBV in resource-constrained settings.

Original languageEnglish (US)
Pages (from-to)755-761
Number of pages7
JournalLiver international : official journal of the International Association for the Study of the Liver
Issue number6
StatePublished - Jul 2011

ASJC Scopus subject areas

  • Hepatology


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