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Improving outcomes for patients with chronic hepatitis B

Authors

  • Robert G. Gish

    1. Departments of Medicine and Transplantation, Division of Hepatology and Complex GI, Physicians Foundation, California Pacific Medical Center, San Francisco, California, USA
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  • Conflict of Interest: Robert Gish, MD, has a financial interest/relationship or affiliation in the form of: Grant/Research Support: Bristol-Myers Squibb Company, Eximias, F. Hoffman-LaRoche Ltd, Gilead Sciences, InterMune Pharmaceuticals, Inc., Ortho Biotech, Schering-Plough Corporation, SciClone Pharmaceuticals, Ucyclyd, Valeant Pharmaceuticals, Pfizer, IDUN, Idenix/Novartis, PowderMed, GlobeImmune.
    Consultant: Amgen Inc., Anadys Pharmaceuticals, Inc., Bayer AG, Bristol-Myers Squibb Company, Chiron Corporation, Corixa Corporation, Eximias, F. Hoffmann-LaRoche Ltd, Gilead Sciences, GlaxoSmithKline, Human Genome Sciences, InterMune Pharmaceuticals, Inc., Metabasis Therapeutics, Ortho Biotech Products, Schering-Plough Corporation, SciClone Pharmaceuticals, United Therapeutics, Valeant Pharmaceuticals, XTL Biopharmaceuticals, Zymogenetics, Inc., Metabasis Therapeutics, Pharmasset, Idenix, Hepahope, Nucleonics, Innogenetics, PowderMed, GlobeImmune, Pharmasset.
    Speakers Bureau: Bayer AG, Bristol-Myers Squibb Company, Eximias, F. Hoffman-LaRoche Ltd, Gilead Sciences Inc., GlaxoSmithKline, nterMune Pharmaceuticals, Inc., Ortho Biotech Products, Schering-Plough Corporation, Valeant Pharmaceuticals, Salix.

Robert G. Gish, 2340 Clay Street, Room 223, California Pacific Medical Center, San Francisco, CA 94115, USA. Email: gishr@sutterhealth.org

Abstract

A focused meeting on hepatitis B virus (HBV) infection was held at the United States National Institutes of Health in Washington, DC, in April 2006. This meeting focused on new and historical data and served as a review for basic scientists and clinicians, as well as representatives from the pharmaceutical industry. Understanding HBV disease must include up-to-date information concerning virology, immunology, animal models, natural history, prevalence, and transmission risk, as well as an understanding of the evolving therapies for this life-threatening infection. Serious outcomes such as advanced fibrosis, cirrhosis, liver failure and hepatocellular carcinoma from hepatitis B infection appear to be closely tied to both historical and current serum levels of HBV DNA, and elevated serum levels of liver enzymes. Decreasing risk events and vaccinating susceptible individuals are key steps in managing this global scourge. New oral treatments for patients withchronic hepatitis B infection characterized by more potent antiviral effects, less toxicity, and minimal or no risk of resistance were reviewed and emphasized. Entecavir and pegylated interferons have recently been approved for treatment of chronic hepatitis B. Further expansion of our information about lamivudine and adefovir were highlighted. Several other new anti-HBV agents are also in phase II or III clinical trials or have been submitted for licensing including LdT (telbivudine). The NIH review meeting is summarized in this review and new and emerging areas of information are highlighted.

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