A hepatitis B- és D-vírus-fertőzés diagnosztikája, antivirális kezelése. Magyar konszenzusajánlás. Érvényes: 2017. szeptember 22-től

Gábor Horváth, Zsuzsanna Gerlei, Judit Gervain, G. Lengyel, Mihály Makara, A. Pár, László Rókusz, F. Szalay, István Tornai, Klára Werling, B. Hunyady

Research output: Article

Abstract

Diagnosis and treatment of hepatitis B virus (HBV) and hepatitis D virus infection mean for the patient to be able to maintain working capacity, to increase quality of life, to prevent cancer, and to prolong life expectancy, while the society benefits from eliminating the chances of further transmission of the viruses, and decreasing the overall costs of serious complications. The guideline delineates the treatment algorithms from 22 September 2017 set by a consensus meeting of physicians involved in the treatment of these diseases. The prevalence of HBV infection in the Hungarian general population is 0,5-0,7%. The indications of treatment are based upon viral examinations (including viral nucleic acid determination), determinations of disease activity and stage (including biochemical, pathologic, and/or non-invasive methods), and excluding contraindications. To avoid unnecessary side effects and for a cost-effective approach, the guideline stresses the importance of quick and detailed virologic evaluations, the applicability of transient elastography as an acceptable alternative of liver biopsy in this regard as well as the relevance of appropriate consistent follow-up schedule for viral response during therapy. The first choice of therapy in chronic HBV infection can be pegylated interferon for 48 weeks or continuous entecavir or tenofovir therapy. The latter two must be continued for at least 12 months after hepatitis B surface antigen seroconversion. Lamivudine is no longer the first choice; patients currently taking lamivudine must switch if the response is inadequate. Appropriate treatment of patients taking immunosuppressive medications is highly recommended. Pegylated interferon based therapy is recommended for the treatment of concomitant hepatitis D infection. Orv Hetil. 2018; 159(Suppl 1): 24-37.

Translated title of the contributionDiagnosis and treatment of chronic hepatitis B and D. National consensus guideline in Hungary from 22 September 2017
Original languageHungarian
Pages (from-to)24-37
Number of pages14
JournalOrvosi hetilap
Volume159
DOIs
Publication statusPublished - febr. 1 2018

Fingerprint

Chronic Hepatitis D
Hungary
Chronic Hepatitis B
Guidelines
Virus Diseases
Hepatitis B virus
Therapeutics
Lamivudine
Tenofovir
Interferons
Hepatitis D
Hepatitis Delta Virus
Elasticity Imaging Techniques
Costs and Cost Analysis
Immunosuppressive Agents
Hepatitis B Surface Antigens
Life Expectancy
Nucleic Acids
Appointments and Schedules

Keywords

  • adefovir
  • cirrhosis
  • entecavir
  • hepatitis B virus
  • hepatitis B-vírus
  • hepatitis D virus
  • hepatitis D-vírus
  • interferon
  • lamivudin
  • lamivudine
  • liver cancer
  • májrák
  • májzsugor
  • pegilált interferon
  • pegylated interferon
  • tenofovir
  • viral hepatitis
  • vírushepatitis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A hepatitis B- és D-vírus-fertőzés diagnosztikája, antivirális kezelése. Magyar konszenzusajánlás. Érvényes : 2017. szeptember 22-től. / Horváth, Gábor; Gerlei, Zsuzsanna; Gervain, Judit; Lengyel, G.; Makara, Mihály; Pár, A.; Rókusz, László; Szalay, F.; Tornai, István; Werling, Klára; Hunyady, B.

In: Orvosi hetilap, Vol. 159, 01.02.2018, p. 24-37.

Research output: Article

Horváth, Gábor ; Gerlei, Zsuzsanna ; Gervain, Judit ; Lengyel, G. ; Makara, Mihály ; Pár, A. ; Rókusz, László ; Szalay, F. ; Tornai, István ; Werling, Klára ; Hunyady, B. / A hepatitis B- és D-vírus-fertőzés diagnosztikája, antivirális kezelése. Magyar konszenzusajánlás. Érvényes : 2017. szeptember 22-től. In: Orvosi hetilap. 2018 ; Vol. 159. pp. 24-37.
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abstract = "Diagnosis and treatment of hepatitis B virus (HBV) and hepatitis D virus infection mean for the patient to be able to maintain working capacity, to increase quality of life, to prevent cancer, and to prolong life expectancy, while the society benefits from eliminating the chances of further transmission of the viruses, and decreasing the overall costs of serious complications. The guideline delineates the treatment algorithms from 22 September 2017 set by a consensus meeting of physicians involved in the treatment of these diseases. The prevalence of HBV infection in the Hungarian general population is 0,5-0,7{\%}. The indications of treatment are based upon viral examinations (including viral nucleic acid determination), determinations of disease activity and stage (including biochemical, pathologic, and/or non-invasive methods), and excluding contraindications. To avoid unnecessary side effects and for a cost-effective approach, the guideline stresses the importance of quick and detailed virologic evaluations, the applicability of transient elastography as an acceptable alternative of liver biopsy in this regard as well as the relevance of appropriate consistent follow-up schedule for viral response during therapy. The first choice of therapy in chronic HBV infection can be pegylated interferon for 48 weeks or continuous entecavir or tenofovir therapy. The latter two must be continued for at least 12 months after hepatitis B surface antigen seroconversion. Lamivudine is no longer the first choice; patients currently taking lamivudine must switch if the response is inadequate. Appropriate treatment of patients taking immunosuppressive medications is highly recommended. Pegylated interferon based therapy is recommended for the treatment of concomitant hepatitis D infection. Orv Hetil. 2018; 159(Suppl 1): 24-37.",
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