Update of chronic hepatitis B

Purpose of review We review here new developments in chronic hepatitis B (CHB) treatment, based on review of published articles between December 2009 and November 2010. Recent findings It is estimated that two-thirds of US CHB patients have not been identified, evaluated and appropriately treated, largely due to lack of knowledge and awareness of CHB among medical professionals and at-risk populations. Seven medications have been approved to treat CHB in adults, but only four medications have been approved to treat CHB in children. Hepatitis B e antigen (HBeAg) seroconversion is still an important treatment endpoint in HBeAg-positive patients. Durability of nucleoside analogue treatment-related HBeAg seroconversion is still questionable. Hepatitis B surface antigen (HBsAg) seroclearance has been achieved in some patients with antiviral therapy. HBsAg quantitation and kinetics is now being studied to determine its role in the natural history of CHB and whether these measures may predict future response to current antiviral therapy. Summary Great advances have been made in understanding the HBeAg seroconversion durability. The clinical significance of serum HBsAg kinetics has been recognized in naive CHB patients and patients with antiviral therapy. More education programs are needed to improve the public awareness of the importance of CHB to the health of whole population.