@article{69e00a4310d045d08eadd6a25a944ac1,
title = "An expert consensus for the management of chronic hepatitis B in Asian Americans",
abstract = " Background: Hepatitis B virus (HBV) infection is common with major clinical consequences. In Asian Americans, the HBsAg carrier rate ranges from 2% to 16% which approximates the rates from their countries of origin. Similarly, HBV is the most important cause of cirrhosis, hepatocellular carcinoma (HCC) and liver related deaths in HBsAg positive Asians worldwide. Aim: To generate recommendations for the management of Asian Americans infected with HBV. Methods: These guidelines are based on relevant data derived from medical reports on HBV from Asian countries as well as from studies in the HBsAg positive Asian Americans. The guidelines herein differ from other recommendations in the treatment of both HBeAg positive and negative chronic hepatitis B (CHB), in the approach to HCC surveillance, and in the management of HBV in pregnant women. Results: Asian American patients, HBeAg positive or negative, with HBV DNA levels >2000 IU/mL (>10 4 copies/mL) and ALT values above normal are candidates for anti-viral therapy. HBeAg negative patients with HBV DNA >2000 IU/mL and normal ALT levels but who have either serum albumin <3.5 g/dL or platelet count <130 000 mm 3 , basal core promoter (BCP) mutations, or who have first-degree relatives with HCC should be offered treatment. Patients with cirrhosis and detectable HBV DNA must receive life-long anti-viral therapy. Indications for treatment include pregnant women with high viraemia, coinfected patients, and those requiring immunosuppressive therapy. In HBsAg positive patients with risk factors, life-long surveillance for HCC with alpha-fetoprotein (AFP) testing and abdominal ultrasound examination at 6-month intervals is required. In CHB patients receiving HCC treatments, repeat imaging with contrast CT scan or MRI at 3-month intervals is strongly recommended. These guidelines have been assigned to a Class (reflecting benefit vs. risk) and a Level (assessing strength or certainty) of evidence. Conclusions: Application of the recommendations made based on a review of the relevant literature and the opinion of a panel of Asian American physicians with expertise in HBV treatment will inform physicians and improve patient outcomes.",
author = "Tong, {M. J.} and Pan, {C. Q.} and Han, {S. H.B.} and Lu, {D. S.K.} and S. Raman and Hu, {K. Q.} and Lim, {J. K.} and Hann, {H. W.} and Min, {A. D.}",
note = "Funding Information: Declaration of personal interests: Myron J. Tong has served on advisory boards for Gilead, and is a speaker for Gilead and Merck. Calvin Q. Pan has served on advisory boards for AbbVie and Gilead. He has served as a consultant for Gilead and has received research grants from Merck and Gilead. He has served as a speaker for AbbVie and Gilead. Steven-Huy B. Han has served as a speaker for Gilead and has received research grants from Gilead. David S-K Lu has served as a speaker, a consultant and an advisory board member for Neuwave, Amgen, Perseon, and has received research funding from Neuwave. Steven Raman has served as a consultant for Bayer, Johnson and Johnson and Amgen. Ke-Qin Hu has served as a speaker, a consultant and an advisory board member for Gilead, Merck, and Intercept. Joseph K. Lim has received research contracts (to institution) from Allergan, Conatus, Genfit, Gilead, Hologic, Intercept, and Prometheus, and has served as a consultant to AbbVie, Bristol-Myers Squibb, and Gilead. Hie-Won Hann has served on the advisory board for Gilead and has received clinical research grant support from Gilead. Albert D. Funding Information: Funding information Independent grants to the Gi Health Foundation from Bristol Myers Squibb and Gilead Sciences, Inc. were used to help support the development of these recommendations Editorial services were provided by William Perlman, PhD, and Thomas Saenz. Declaration of personal interests: Myron J. Tong has served on advisory boards for Gilead, and is a speaker for Gilead and Merck. Calvin Q. Pan has served on advisory boards for AbbVie and Gilead. He has served as a consultant for Gilead and has received research grants from Merck and Gilead. He has served as a speaker for AbbVie and Gilead. Steven-Huy B. Han has served as a speaker for Gilead and has received research grants from Gilead. David S-K Lu has served as a speaker, a consultant and an advisory board member for Neuwave, Amgen, Perseon, and has received research funding from Neuwave. Steven Raman has served as a consultant for Bayer, Johnson and Johnson and Amgen. Ke-Qin Hu has served as a speaker, a consultant and an advisory board member for Gilead, Merck, and Intercept. Joseph K. Lim has received research contracts (to institution) from Allergan, Conatus, Genfit, Gilead, Hologic, Intercept, and Prometheus, and has served as a consultant to AbbVie, Bristol-Myers Squibb, and Gilead. Hie-Won Hann has served on the advisory board for Gilead and has received clinical research grant support from Gilead. Albert D. Min has served as a speaker for AbbVie, Gilead and Merck and an advisory board member for AbbVie, Gilead and Merck. Publisher Copyright: {\textcopyright} 2018 The Authors. Alimentary Pharmacology & Therapeutics Published by John Wiley & Sons Ltd.",
year = "2018",
month = apr,
doi = "10.1111/apt.14577",
language = "English",
volume = "47",
pages = "1181--1200",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "8",
}