For more information about the AHF and its members, please visit:
|
|
- Jodie Johnson
- 6 years ago
- Views:
Transcription
1
2 The Asian Health Foundation (AHF) is a nonprofit organization that comprises more than 40 physicians dedicated to improving the health of Asian Americans and Pacific Islanders. For more information about the AHF and its members, please visit:
3 Christopher Bui, MD Gastroenterologist Fountain Valley Regional Hospital Huntington Beach Hospital Westminster, CA Danny Chu, MD Clinical Instructor Albert Einstein College of Medicine New York, NY Son T. Do, MD Past Chairman National Task Force for Hepatitis B, API University of Texas Southwestern Medical School Dallas, TX Hie-Won Hann, MD Professor of Medicine Jefferson Medical College of Thomas Jefferson University Director, Liver Disease Prevention Center Thomas Jefferson University Hospital Philadelphia, PA Kris V. Kowdley, MD Director, Liver Center of Excellence Virginia Mason Medical Center Seattle, WA Albert Min, MD Professor of Clinical Medicine Albert Einstein College of Medicine Director of Hepatology Beth Israel Medical Center New York, NY Mindie Nguyen, MD, MAS Assistant Professor, Gastroenterology and Hepatology Stanford University Palo Alto, CA Helen Te, MD Associate Professor of Medicine University of Chicago Medicine Medical Director, Adult Liver Transplantation Chicago, IL Tram T. Tran, MD Associate Professor of Medicine Geffen UCLA School of Medicine Medical Director, Liver Transplant Program Cedars-Sinai Medical Center Los Angeles, CA Naoky Tsai, MD Naoky Tsai, MD Professor of Medicine, University of Hawaii Director, Liver Center at Queens Medical Center Honolulu, HI
4 Christopher Bui, MD, has no real or apparent conflicts of interest to report, nor any financial relationships to disclose. Danny Chu, MD Consulting Fees: Bristol-Myers Squibb; Gilead Sciences, Inc. Fees for Non-CME Services: Bristol-Myers Squibb; Gilead Sciences, Inc. Son T. Do, MD Consulting Fees: Bristol-Myers Squibb; Gilead Sciences, Inc. Contracted Research: Bristol-Myers Squibb; National Institutes of Health Fees for Non-CME Services: Asian Health Foundation; Bristol-Myers Squibb; Gilead Sciences, Inc. Hie-Won Hann, MD Consulting Fees: Bristol-Myers Squibb; Gilead Sciences, Inc; Novartis Contracted Research: Bristol-Myers Squibb; Gilead Sciences, Inc. Other (Spouse): Gilead Sciences, Inc. Kris V. Kowdley, MD Consulting Fees: Abbott; Gilead Sciences, Inc; Novartis; Vertex (payable to the institution)
5 Albert Min, MD Consulting Fees: Bayer; Gilead Sciences, Inc; Vertex Contracted Research: Bristol-Myers Squibb; Gilead Sciences, Inc; Vertex Fees for Non-CME Services: Bristol-Myers Squibb; Gilead Sciences, Inc; Merck; Salix; Vertex Mindie Nguyen, MD, MAS Consulting Fees: Bristol-Myers Squibb; Novartis Contracted Research: Bristol-Myers Squibb; Gilead Sciences, Inc; Novartis Helen Te, MD has no real or apparent conflicts of interest to report, nor any financial relationships to disclose. Tram T. Tran, MD Consulting Fees: Bristol-Myers Squibb; Gilead Sciences, Inc. Naoky Tsai, MD Consulting Fees: Bristol-Myers Squibb; Genentech; Gilead Sciences, Inc. Contracted Research: Bristol-Myers Squibb; Gilead Sciences, Inc. Fees for Non-CME Services: Bristol-Myers Squibb; Genentech; Gilead Sciences, Inc.
6 After completing this CME/CE activity, the participant will be better able to: Explain the natural history of hepatitis B virus (HBV) infection in light of its clinical implications for treatment Evaluate currently approved treatments for chronic hepatitis B (CHB) in terms of safety and efficacy Formulate individualized treatment strategies for the duration of therapy
7 This activity is supported by independent educational grants from Bristol-Myers Squibb and Gilead Sciences Medical Affairs.
8
9 55 years old/m, born in China, came to the United States at age 40 years, visited a physician for a life-insurance checkup
10 Persons 2 million 1.5 million 1 million 1.4 million- 2 million Having more potent drugs will not improve effectiveness if diagnosis and access to care are not improved High estimate Low estimate 500, , , , , , ,000 0 Chronically Infected Aware of Infection Potentially Eligible for Treatment Entering Care 50,000 Annual HBV Prescriptions Cohen C, et al. J Viral Hepat. 2011;18:
11 Blood, organ, plasma, semen, tissue donors Hemodialysis patients All pregnant women Infants born to HBsAg-positive women Household contacts, needle-sharing, or sex partners of HBV-infected persons Sources of blood or body-fluid exposures that might warrant postexposure prophylaxis Persons born in countries with HBsAg prevalence 2% HIV-infected persons Persons with select medical conditions (eg, elevated ALT or AST levels of unknown etiology) Persons with behavioral exposures (eg, IDUs, MSM) Unvaccinated children of persons from countries with 8% prevalence AST, aspartate aminotransferase; IDU, injection drug user; MSM, men who have sex with men. Centers for Disease Control and Prevention. MMWR. 2008;57:1-20.
12 HBsAg Prevalence 8% - high 2% 7% - intermediate <2% - low Centers for Disease Control and Prevention. MMWR. 2008;57:1-20.
13 Phase ALT Liver Histology HBV DNA HBeAg HBsAg Immunetolerance phase Normal or minimally elevated Minimal activity; absent or scant fibrosis High levels: HBV DNA >20,000 IU/mL Positive; anti- HBe negative Positive >6 months Immune - clearance phase (HBeAg positive) Elevated, persistently or intermittently Active; liver biopsy showing chronic hepatitis High levels: HBV DNA >20,000 IU/mL Positive; anti- HBe negative Positive >6 months Inactive HBsAg carrier state Persistently normal Inactive; liver biopsy showing variable, usually minimal, fibrosis Low or undetectable levels: HBV DNA negative or <2000 IU/mL Negative; anti- HBe positive Positive >6 months Resolution Normal Inactive; scant fibrosis No detectable HBV DNA Negative; anti- HBe positive Negative Reactivation phase (HBeAg negative) Elevated, often fluctuating levels Active: liver biopsy showing variable amounts of fibrosis Moderate, often fluctuating levels: HBV DNA >2000 IU/mL Negative; anti- HBeAg positive Positive >6 months Keeffe EB, et al. Clin Gastroenterol Hepatol. 2008;6:
14 HBV DNA HBeAg Anti-HBe HBsAg Anti-HBc Anti-HBc IgM Months Years Anti-HBc, antibody to the hepatitis B core antigen; IgM, immunoglobulin M. Centers for Disease Control and Prevention. MMWR. 2008;57:1-20.
15 Test for both HBsAg and anti-hbs Lok ASF, et al. Hepatology. 2009;50:1-36. Patient Status Test Result Chronic infection Susceptible Immune HBsAg positive Anti-HBs negative HBsAg negative Anti-HBs negative HBsAg negative Anti-HBs positive
16
17 Screening test results: HBsAg positive, anti-hbs negative Additional tests showed: ALT 36 HBeAg negative, anti-hbe positive HBV DNA 110 IU/mL (about 550 copies/ml) After 6 months of follow-up: ALT 59 HBV DNA 7375 IU/mL A decision to treat the patient was made Because of HBeAg-negative infection, duration of therapy was indefinite
18 First-line agents Pegylated interferon (PegIFN) alfa-2a (Pegasys ) Injectable Entecavir (ETV) (Baraclude ) Oral Tenofovir (TDF) (VIREAD ) Oral Second-line agents Pegylated intereron (PegIFN) alfa-2b (Intron ) Injectable Lamivudine (LAM) (Epivir HBV ) Oral Adefovir (ADV) dipivoxil (Hepsera ) Oral Telbivudine (TBV) (Tyzeka ) Oral
19 HBeAg+ HBeAg- Patients, % a,b ADV ETV TDF c d a Marcellin P, et al. Hepatology. 2008;48: b Hadziyannis SJ, et al. Gastroenterology. 2006;131: c Han S et al, Hepatology. 2008;48:705A. d Marcellin P, et al. Hepatology. 2011;54:1011A.
20 HBeAg Seroconversion, % HBeAg Seroconversion, % At 1 Year b >1 Year b PegIFN LAM ADV ETV TBV TDF PegIFN LAM ADV ETV (3.5 y) (3 y) (5 y) (5 y) TBV TDF (4 y) (5 y) c a Not head-to-head trials. b Scaglione SJ, et al. Gastroenterology. 2012;142: c Marcellin P, et al. Hepatology. 2011;54:1011A.
21 60 Year 1 Patients With Seroconversion, % b b c c c Year 2 Year 3 Year 4 Year 5 0 ETV 1-5 TDF 6-9 a Not head-to-head trials; different patient populations and trial designs; b includes only patients from TDF study arm; c includes patients in Year 1 ADV study arm who were switched to TDF at end of Year 1 plus patients who had been on TDF from Day 1. 1 Chang TT, et al. N Engl J Med. 2006;354: Gish R, et al. Gastroenterology. 2007;133: Chao Y-C, et al. Hepatology. 2006;44:229A. 4 Han S, et al. Hepatology. 2007;46:654A. 5 Chang TT, et al. Hepatology. 2010;52: Marcellin P, et al. N Engl J Med. 2008;359: Heathcote EJ, et al. Hepatology. 2008;48:376A. 8 Heathcote EJ, et al. Gastroenterology. 2011;140: Heathcote EJ, et al. Hepatology. 2010;52:556A-557A. 10 Marcellin P, et al. Hepatology. 2011;54:1011A.
22 HBsAg Loss, % HBsAg Loss, % PegIFN (3.5 y) 8 PegIFN (3 y) 3 0 NA 2 LAM ADV ETV (2-3 y) (5 y) (5 y) LAM (4 y) HBeAg+ Patients a 5 NA 5 HBeAg- Patients a ADV (5 y) NA ETV TBV TDF (2 y) (5 y) TBV (2 y) TDF (5 y) a Not head-to-head trials. Scaglione SJ, et al. Gastroenterology. 2012;142:
23 Bridging fibrosis or cirrhosis, HBeAg+/HBV DNA >700,000 meq/ml 25 Increased CTP score, liver failure, or HCC Persons With Disease Progression, % Placebo 21% n = 43 P =.001 n = 173 9% n = 198 n = 385 LAM n = Time to Disease Progression, Months Placebo (n = 215) ITT population LAM (n = 436) P =.001 CTP, Child-Turcotte-Pugh; HCC, hepatocellular carcinoma; ITT, intent to treat. Liaw YF, et al. N Engl J Med. 2004;351:
24 Subjects, % (n = 10) (n = 126) (n = 79) (n = 37) (n = 19) (n = 77) Baseline Ishak Fibrosis Score 96% (335/348) of patients with paired biopsies either improved ( 1 unit decrease in fibrosis score) or did not change at Year 5 96% (318/331) who did not add FTC either improved or did not change at Year 5 98% of patients on TDF treatment had undetectable HBV DNA <400 copies/ml at Year 5 FTC, emtricitabine. Marcellin P, et al. AASLD 2011; San Francisco, CA; November 4-8, Poster Year 5 Response Improvement No change Worsening
25 The patient asks about the SEs of the medication and the safety of the indefinite duration of therapy What would you tell him? SE, side effect.
26 AEs Frequency (n = 1051) Myalgia 54 (5%) Neuropathy 42 (4%) Increased lipase 24 (2%) Increased serum creatinine 8 (<1%) Lactate increase or bicarbonate decrease 6 (<1%) Hypophosphatemia 5 (<1%) Muscular weakness 4 (<1%) Pancreatitis 3 (<1%) Creatinine phosphokinase elevation 2 (<1%) Manns MP, et al. Expert Opin Drug Saf. 2012;11:
27 ETV 31% lactic acidosis in 1 case series of decompensated cirrhosis (particularly MELD 20) 1 TDF 15% decreased bone mineral density in HIV patients 2 Nephrotoxicity, 3 better defined (34%) in HIV patients 4 ADV 3%-21% nephrotoxicity 5-7 TVD 1.4% myopathy, 0.3% peripheral neuropathy 8,9 MELD, model for end-stage liver disease. 1 Lange CM, et al. Hepatology. 2009;50: Vigano et al. Hepatology. 2011;54:1016A. 3 Gara et al. Hepatology. 2011;54:479A. 4 Scherzer R, et al. AIDS. 2012; in press. 5 Schiff E, et al. Liver Transpl. 2007;13: Marcellin P, et al. Hepatology. 2008;48: Hadziyannis SJ, et al. Gastroenterology. 2006;131: Fleischer Rd, et al. J Hepatology. 2009;51: Goncalves J, et al. J Hepatology. 2009;50:S329.
28 Year 1 Year 2 72 Weeks Year 3 Year 4 Year 5 Year 6 LAM 1 23% 46% 55% 71% 80% ADV a,1 0% 3% 11% 18% 29% TBV b,2,3 5% 25% TDF c,4 0% 0% c 0% c 0% c 0% ETV d,5 <1% <1% 1.2% 1.2% 1.2% 1.2% a Naive HBeAg-; b naive HBeAg+; c patients with HBV DNA 400 copies/ml at Week 72 could add FTC to TDF; d cumulative probabilities of resistance taken. 1 Locarnini S. Hepatol Int. 2008;2: ; 2 Lai CL, et al. N Engl J Med. 2007;357: ; 3 Liaw YF, et al. Gastroenterology. 2009;136: ; 4 Marcellin P, et al. Hepatology. 2011;54:1011A-1012A; 5 Tenney DJ, et al. Hepatology. 2009;49:
29
30 Efficacy Utility of a medical treatment evaluated under optimal conditions Highly selected, motivated patients Experienced physicians: standardized algorithm for monitoring and management of suboptimal response or breakthroughs Free medications, evaluations, and tests Effectiveness Utility of a medical treatment in routine clinical settings, ie, real life All comers All physicians Costs borne by health insurance and/or patients Scaglione SJ, et al. Gastroenterology.2012;142:
31 Aware of Diagnosis IOM About 35% Diagnosis Referred and Linked to Care About 40%, Lower in Community Screening Programs Evaluation Barriers to Diagnosis and Linkage to Care Providers Knowledge, recognition of risk factors Resources, reimbursement Infected Persons Awareness of risks, consequences, and availability of treatment Fear of social stigmatization Language and cultural barriers Access to care IOM, Institute of Medicine. Scaglione SJ, et al. Gastroenterology. 2012; 142:
32 Meet criteria for treatment Physician knowledge Evaluation Follow-up of those who do not meet criteria for treatment Do not meet criteria for treatment Treatment recommended Patients acceptance Treatment started Concerns about: Need Duration of treatment SEs Costs Scaglione SJ, et al. Gastroenterology. 2012; 142:
33 Virologic Response Patient: Immune status Virus: HBV genotype, baseline HBV DNA Disease: ALT, cirrhosis Medication: potency, genetic barrier to resistance Treatment initiated HBV DNA suppressed Clinical benefit Medication Adherence Tolerance/AEs Affordability/costs Scaglione SJ, et al. Gastroenterology. 2012;142:
34 Phase III clinical trials 13%-100% of patients with VBTs not associated with emergence of drug-resistant mutations Medication nonadherence may be responsible for VBT in these patients Adherence in clinical practice likely lower Patients less motivated, have more comorbid conditions Monitoring less frequent Medications have to be paid for VBT, virologic breakthrough. Scaglione SJ, et al. Gastroenterology. 2012; 142:
35 Pharmacy-claims database in the United States 3 cohorts of CHB patients receiving LAM, ADV, ETV, or TDF (2009 cohort only) in January 2007, 2008, and 2009 followed for 1 year New patients = patients started on treatment in January of that year (n = 458) Existing patients = patients who had been on treatment in the prior year (n = 10,295) Persistence = percentage of patients who continued to refill the medication during that year Adherence = percentage of days during that year in which patients had medications Chotiyaputta W, et al. J Hepatol. 2011;54:12-18.
36 Pharmacy refill rates declined sharply in first 6 months, particularly among patients newly started on treatment Pharmacy refill persisted until the end of the year in: 73.4% of new patients 81.4% of existing patients Chotiyaputta W, et al. J Hepatol. 2011;54: Persistence Rate, % Persistence Rate, % Time, Months Existing Patients LAM (n = 88) ADV (n = 210) ETV (n = 195) TDF (n = 25) ALL (n = 518) Time, Months New Patients LAM (n = 88) ADV (n = 210) ETV (n = 195) TDF (n = 25) ALL (n = 518)
37 New Patients (n = 458) Existing Patients (n = 10,295) >95% %-95% 81%-90% 71%-80% 61%-70% 51%-60% <50% About 20% of patients had <80% adherence over a 1-year study period Chotiyaputta W, et al. J Hepatol. 2011;54:12-18.
38 Prospective study of 111 patients treated in a tertiary liver center Adherence assessed by provider inquiry and patient selfreporting in questionnaire Adherence defined as number of missed doses in past 30 days 73% patients reported 100% adherence in questionnaire 84% patients reported 100% adherence to health care providers Chotiyaputta W, et al. J Hepatol. 2011;54:12-18.
39 20 Patients With VBT Percentage % in 3/3 Adherence <100% in 2/3 <100% in 1/3 Questionnaire Chotiyaputta W, et al. J Viral Hepat. 2012;19:
40 Discontinuation of and nonadherence to HBV nucleos(t)ide analogs during long-term treatment of CHB is common and may result in VBT, treatment failure, and drug resistance Adherence rates reported to health care providers may be inflated
41 Pharmacy Reminders to patients Alerts to health care providers Health care providers Directed inquiries into adherence Education, counseling, repeated emphasis Education materials More frequent clinic visits and drug refills Patients Place medication in a prominent location Take medication at the same time each day Organize medications in a pillbox Family and caregivers Reminders Organize medications in a pillbox
42 Costs Medications (average wholesale price) TDF/ETV x 1 year about $10,000 (copay $240-$3600) Average duration of treatment >5 years PegIFN x 48 weeks $30,000 Lab monitoring HBV DNA, HBeAg, HBsAg Chemistry: ALT (liver panel), creatinine, phosphorus CBC, TSH (for IFN) Physician visits CBC, complete blood count; IFN, interferon; pegifn, pegylated interferon; TSH, thyroid-stimulating hormone.
43 Increasing the effectiveness of HBV management in clinical practice requires: Awareness of the risk for the disease to allow for diagnosis Access to medical care after diagnosis has been made Appropriate evaluation to determine the need for therapy Initiation of appropriate drugs and ability to procure medication Adherence to medication during therapy Continuing access to medical care to allow for consistent monitoring and follow-up during therapy
44 Long-term therapy with nucleos(t)ides requires adherence to medication and the use of drugs with high barrier to resistance Long-term therapy also requires surveillance for AEs of the drugs
Management of Chronic Hepatitis B in Asian Americans
Management of Chronic Hepatitis B in Asian Americans Myron J Tong; UCLA, CA Calvin Q. Pan; Mount Sinai, NY Hie-Won Hann; Thomas Jefferson, PA Kris V. Kowdley; Virginia Mason, WA Steven Huy B Han; UCLA,
More informationIs there a need for combination therapy? No. Maria Buti Hospital General Universitario Valle Hebron Barcelona. Spain
Is there a need for combination therapy? No Maria Buti Hospital General Universitario Valle Hebron Barcelona. Spain No, No and No EASL Update HBV Guidelines 2012 The most potent drugs with the optimal
More informationNUCs for Chronic Hepatitis B. Rafael Esteban Hospital Universitario Valle Hebron and Ciberehd del Instituto Carlos III. Barcelona.
NUCs for Chronic Hepatitis B Rafael Esteban Hospital Universitario Valle Hebron and Ciberehd del Instituto Carlos III. Barcelona. Spain Disclosures Advisory board of, and/or, received speaker fee from
More informationHepatitis B Virus therapy. Maria Buti Hospital Universitario Valle Hebron Barcelona Spain
Hepatitis B Virus therapy Maria Buti Hospital Universitario Valle Hebron Barcelona Spain Disclosures Advisor: AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck Sharp &
More informationHepatitis B Treatment Pearls. Agenda
Hepatitis B Treatment Pearls Fredric D. Gordon, MD Vice Chair Dept. of Transplantation and Hepatobiliary Diseases Lahey Hospital & Medical Center Associate Professor of Medicine Tufts Medical School Boston,
More informationHepatitis B Virus therapy. Maria Buti Hospital Universitario Valle Hebron Barcelona Spain
Hepatitis B Virus therapy Maria Buti Hospital Universitario Valle Hebron Barcelona Spain Disclosures Advisor: AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck Sharp &
More informationHBV Therapy in Special Populations: Liver Cirrhosis
HBV Therapy in Special Populations: Liver Cirrhosis Universitätsklinikum Leipzig Thomas Berg Sektion Hepatologie Klinik und Poliklinik für Gastroenterologie und Rheumatologie Leber- und Studienzentrum
More informationHBV Diagnosis and Treatment
HBV Diagnosis and Treatment Anna S. F. Lok, MD Alice Lohrman Andrews Professor in Hepatology Director of Clinical Hepatology Assistant Dean for Clinical Research University of Michigan Ann Arbor, MI, USA
More informationChronic Hepatitis B: management update.
Chronic Hepatitis B: management update. E.O.Ogutu Department of clinical medicine & therapeutics, University of Nairobi. Physicians meeting,kisumu 2011. Background epidemiology Chronic hepatitis B (CHB)
More informationThe Impact of HBV Therapy on Fibrosis and Cirrhosis
The Impact of HBV Therapy on Fibrosis and Cirrhosis Jordan J. Feld, MD, MPH Associate Professor of Medicine University of Toronto Hepatologist Toronto Centre for Liver Disease Sandra Rotman Centre for
More informationDrug Class Monograph
Drug Class Monograph Class: Chronic Hepatitis B Drug: Baraclude (entecavir), Epivir (lamivudine), Hepsera (adefovir), Intron A (interferon alfa- 2b), Pegasys (peginterferon alfa-2a), Tyzeka (telbivudine),
More informationHBeAg-positve chronic hepatts B: Why do I treat my patent with a NA? Maria But
HBeAg-positve chronic hepatts B: Why do I treat my patent with a NA? Maria But Hospital Universitario Valle Hebron and Ciberehd del Insttuto Carlos III. Barcelona. Spain Disclosures Advisory board of,
More informationTreatment as a form of liver cancer prevention The clinical efficacy and cost effectiveness of treatment across Asia
Treatment as a form of liver cancer prevention The clinical efficacy and cost effectiveness of treatment across Asia Prof. Henry LY Chan Head, Division of Gastroenterology and Hepatology Director, Institute
More informationCURRENT TREATMENT. Mitchell L Shiffman, MD Director Liver Institute of Virginia Bon Secours Health System Richmond and Newport News, Virginia
CURRENT TREATMENT OF HBV Mitchell L Shiffman, MD Director Liver Institute of Virginia Bon Secours Health System Richmond and Newport News, Virginia CHRONIC HBV INFECTION DEMOGRAPHICS IN THE USA Estimated
More informationHepatitis B. ECHO November 29, Joseph Ahn, MD, MS Associate Professor of Medicine Director of Hepatology Oregon Health & Science University
Hepatitis B ECHO November 29, 2017 Joseph Ahn, MD, MS Associate Professor of Medicine Director of Hepatology Oregon Health & Science University Disclosures Advisory board Gilead Comments The speaker Joseph
More informationHepatitis B Prior Authorization Policy
Hepatitis B Prior Authorization Policy Line of Business: Medi-Cal P&T Approval Date: November 15, 2017 Effective Date: January 1, 2018 This policy has been developed through review of medical literature,
More information29th Viral Hepatitis Prevention Board Meeting
29th Viral Hepatitis Prevention Board Meeting Madrid, November 2006 Treatment of chronic hepatitis B José M. Sánchez-Tapias Liver Unit Hospital Clínic University of Barcelona Spain CHRONIC HBV INFECTION
More informationBeyond the Tip of the Iceberg: Strategies to Ensure Optimal HBV Screenin g, Diagnosis, and Initial Therapy
: Strategies to Ensure Optimal HBV Screenin g, Diagnosis, and Initial Therapy Sunday, November 1, 2009 Back Bay Ballroom Sheraton Boston Hotel Boston, Massachusetts This program is supported by an educational
More informationDisclaimer. Presenter Release are for reactive use by Medical Information only internal learning/educational use only
Disclaimer Presenter Release are for reactive use by Medical Information only internal learning/educational use only Any unsolicited request from HCP must be forwarded to Medical Information Housekeeping
More informationManagement of chronic hepatitis B : recent advance in the treatment of antiviral resistance
anagement of chronic hepatitis B : recent advance in the treatment of antiviral resistance / 김강모 연수강좌 anagement of chronic hepatitis B : recent advance in the treatment of antiviral resistance 김강모 울산대학교의과대학서울아산병원소화기내과
More informationManagement of Decompensated Chronic Hepatitis B
Management of Decompensated Chronic Hepatitis B Dr James YY Fung, FRACP, MD Department of Medicine The University of Hong Kong Liver Transplant Center Queen Mary Hospital State Key Laboratory for Liver
More informationWho to Treat? Consider biopsy Treat. > 2 ULN Treat Treat Treat Treat CIRRHOTIC PATIENTS Compensated Treat HBV DNA detectable treat
Who to Treat? Parameter AASLD US Algorithm EASL APASL HBV DNA CRITERIA HBeAg+ >, IU/mL > 2, IU/mL > 2, IU/mL >, IU/mL HBeAg- > 2, IU/mL > 2, IU/mL > 2, IU/mL > 2, IU/mL ALT CRITERIA PNALT 1-2 ULN Monitor
More informationTenofovir as a drug of choice for the chronic hepatitis B treatment
EASL endorsed conference White Nights of Hepatology 2013 Symposium Perspectives of chronic viral hepatitis B and C treatment June 6-7 Saint-Petersburg Tenofovir as a drug of choice for the chronic hepatitis
More informationGAZETTE COMMON GROUND. CHB: A significant and prevalent disease in the US and worldwide. Inside. Screening, diagnosis, and evaluation
VOL III/III COMMON GROUND GAZETTE Inside CASE 1: Screening, diagnosis, and evaluation P. 1 CASE 2: Initiating treatment P. 4 CASE 3: Managing antiviral resistance P. 5 CASE 4: Achieving the maximum effect
More informationMarch 29, :15 PM 1:15 PM San Diego, CA Convention Center Ballroom 20D
March 29, 2017 12:15 PM 1:15 PM San Diego, CA Convention Center Ballroom 20D Provided by #IM2017 This lunch symposium is not part of the official Internal Medicine Meeting 2017 Education Program. #IM2017
More informationHepatitis B. Epidemiology and Natural History and Implications for Treatment
Hepatitis B Epidemiology and Natural History and Implications for Treatment Norah Terrault, MD Professor of Medicine and Surgery Director, Viral Hepatitis Center University of California San Francisco
More informationHigh Rates of Viral Suppression After Long-term Entecavir Treatment of Asian Patients With Hepatitis B e Antigen Positive Chronic Hepatitis B
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2012;10:1047 1050 BRIEF COMMUNICATIONS High Rates of Viral Suppression After Long-term Entecavir Treatment of Asian Patients With Hepatitis B e Antigen Positive
More informationOptimized HBV Treatment Through Baseline and on-treatment Predictor Oral Antiviral Therapy. Watcharasak Chotiyaputta
Optimized HBV Treatment Through Baseline and on-treatment Predictor Oral Antiviral Therapy Watcharasak Chotiyaputta Progression of Liver Disease Goal of HBV Treatment: prevention the development of cirrhosis
More informationDoes Viral Cure Prevent HCC Development
Does Viral Cure Prevent HCC Development Prof. Henry LY Chan Head, Division of Gastroenterology and Hepatology Director, Institute of Digestive Disease Director, Center for Liver Health Assistant Dean,
More informationClinical Policy: Hepatitis B Drugs Reference Number: AZ.CP.PHAR.03 Effective Date: Last Review Date: Line of Business: Arizona Medicaid
Clinical Policy: Reference Number: AZ.CP.PHAR.03 Effective Date: 11.16.16 Last Review Date: 08.18 Line of Business: Arizona Medicaid Revision Log See Important Reminder at the end of this policy for important
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Tyzeka) Reference Number: CP.CPA.164 Effective Date: 11.16.16 Last Review Date: 11.17 Line of Business: Medicaid Medi-Cal Revision Log See Important Reminder at the end of this policy
More informationBasics of hepatitis B diagnostics. Dr Emma Page MRCP MD(Res) Locum Consultant Sexual Health & Virology
Basics of hepatitis B diagnostics Dr Emma Page MRCP MD(Res) Locum Consultant Sexual Health & Virology Basics of hepatitis B diagnostics Background Epidemiology Morphology Life-cycle Diagnostic markers
More informationIndividualizing Treatment in the Patient With Chronic HBV Infection: When to Start, What to Use, and When to Stop CME
Individualizing Treatment in the Patient With Chronic HBV Infection: When to Start, What to Use, and When to Stop CME Chia C. Wang, MD, MS Anna S. F. Lok, MD Kris V. Kowdley, MD Supported by an independent
More informationRecent achievements in the treatment of hepatitis B by nucleosides and nucleotides. K. Zhdanov
EASL endorsed conference White Nights of Hepatology 2012 Adverse events during antiviral therapy: how to predict, manage and monitor June 7-8 Saint-Petersburg Recent achievements in the treatment of hepatitis
More informationNH2 N N N O N O O P O O O O O
N N NH 2 N N O O P O O O O O O James Watson and Francis Crick Double Helix 1953 Baruch Blumberg, MD, PhD 1925-2011 Australia Antigen 1965 Hepatitis B Virus (HBV) Hepadnaviridae member that primarily infects
More informationHBeAg-negative chronic hepatitis B. with a nucleos(t)ide analogue?
4 th PARIS HEPATITIS CONFERENCE HBeAg-negative chronic hepatitis B Why do I treat my chronic hepatitis B patients with a nucleos(t)ide analogue? George V. Papatheodoridis, MD 2nd Department of Internal
More informationHepatitis B Virus. Taylor Page PharmD Candidate 2019 February 1, 2019
Hepatitis B Virus Taylor Page PharmD Candidate 2019 February 1, 2019 Epidemiology 3218 cases of acute HBV reported in 2016 847,000 non-institutionalized persons living with chronic HBV in 2011-2012 Viral
More informationGish RG and AC Gadano. J Vir Hep
Treatment in Hepatitis B and C There are options! Karen F. Murray, MD Professor of Pediatrics Director, Hepatobiliary Program Seattle Children s Hepatitis B Virus Epidemiology and natural history 400
More informationLandmarks for Prevention and Treatment
HBeAg-positive chronic hepatitis B Why do I treat my patient with a nucleos(t)ide analogue? Dr. Nancy Leung BSc(Lon) MSc(Lon) MBBS(Lon) MD(Lon), FRCP(Lon) FRCP(Edin) FHKCP FHKAM Consultant Physician, Alice
More informationPegasys Hepatitis B. Pegasys (peginterferon alfa-2a) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.03.02 Subject: Pegasys Hepatitis B Page: 1 of 5 Last Review Date: September 18, 2015 Pegasys Hepatitis
More informationCornerstones of Hepatitis B: Past, Present and Future
Cornerstones of Hepatitis B: Past, Present and Future Professor Man-Fung Yuen Queen Mary Hospital The University of Hong Kong Hong Kong 1 Outline Past Natural history studies Development of HBV-related
More informationentecavir, 0.5mg and 1mg film-coated tablets and 0.05 mg/ml oral solution, Baraclude SMC No. (747/11) Bristol-Myers Squibb Pharmaceuticals Ltd
entecavir, 0.5mg and 1mg film-coated tablets and 0.05 mg/ml oral solution, Baraclude SMC No. (747/11) Bristol-Myers Squibb Pharmaceuticals Ltd 09 December 2011 The Scottish Medicines Consortium (SMC) has
More informationTreatment of Hepatitis B
Treatment of Hepatitis B Paul Y. Kwo, MD, FACG Professor of Medicine Gastroenterology/Hepatology Division Medical Director, Liver Transplantation Indiana University Health Indiana University School of
More informationChronic HBV Management in 2013
Chronic HBV Management in 2013 Mohammad Hossein Somi MD Professor of Gastroentrology and hepatology Liver and Gastrointestinal Disease Research Center Tabriz University of Medical Sciences 1 HBV in 2013
More informationViral Hepatitis The Preventive Potential of Antiviral Therapy. Thomas Berg
Viral Hepatitis The Preventive Potential of Antiviral Therapy Thomas Berg Therapeutic and preventive strategies in patients with hepatitis virus infection Treatment of acute infection Treatment of chronic
More informationOur better understanding of the natural
TREATMENT OF CHRONIC HEPATITIS B: MASTERING THE BASICS ON A COMPLEX TOPIC Ke-Qin Hu, MD* ABSTRACT The availability of newer antiviral agents, as well as comprehensive treatment recommendations, has equipped
More informationHepatitis B: An Update COPYRIGHT
Hepatitis B: An Update Sanjiv Chopra, M.D. Professor of Medicine Harvard Medical School James Tullis Firm Chief Department of Medicine Beth Israel Deaconess Medical Center A Tale of Serendipity Baruch
More informationHepatocellular Carcinoma: Can We Slow the Rising Incidence?
Hepatocellular Carcinoma: Can We Slow the Rising Incidence? K.Rajender Reddy M.D. Professor of Medicine Director of Hepatology Medical Director of Liver Transplantation University of Pennsylvania Outline
More informationThe Goal of HBV Therapy. Key Points. The Twin Pillars of HBV Therapy
How to Follow Once You tart Hepatitis B Treatment And When To Worry About esistance American College of Gastroenterology October 16, 21 ra Jacobson, MD Vincent Astor Professor of Medicine Chief, Division
More informationA Treatment Algorithm for the Management of Chronic Hepatitis B Virus Infection in the United States: 2015 Update
Accepted Manuscript A Treatment Algorithm for the Management of Chronic Hepatitis B Virus Infection in the United States: 2015 Update Paul Martin, MD, Daryl T.-Y. Lau, MD, MSc, MPH, Mindie H. Nguyen, MD,
More informationAcute Hepatitis B Virus Infection with Recovery
Hepatitis B: Clear as Mud Melissa Osborn, MD, MSCR Assistant Professor Emory University School of Medicine Atlanta, GA 1 Objectives 1. Distinguish the various stages in the natural history of chronic hepatitis
More informationEntecavir Maintains a High Genetic Barrier to HBV Resistance Through 6 Years in Naïve Patients
Entecavir Maintains a High Genetic Barrier to HBV Resistance Through 6 Years in Naïve Patients D.J. Tenney 1, K.A. Pokorowski 1, R.E. Rose 1, C.J. Baldick 1, B.J. Eggers 1, J. Fang 1, M.J. Wichroski 1,
More informationHepatitis B: Future treatment developments
Hepatitis B: Future treatment developments VIII International Update Workshop in Hepatology Curitiba, 27.08.2016 Christoph Sarrazin St. Josefs-Hospital Wiesbaden and Goethe-University, Frankfurt am Main
More informationESCMID Online Lecture Library. by author
Pro-Con: To stop or not to stop hepatitis B treatment? To Stop HBV Treatment Resat Ozaras, MD, Professor Istanbul University, Cerrahpasa Medical School, Infection Dept. HBV Therapy Nucleos(t)ide analogues
More informationUpdate on HBV Treatment
Update on HBV Treatment Calvin Q. Pan MD, FAASLD, FACG, MACP Professor of Medicine Division of Gastroenterology and Hepatology Department of Medicine, NYU Langone Health New York University School of Medicine,
More informationDon t interfere My first choice is always nucs!
Don t interfere My first choice is always nucs! Robert G Gish MD Professor Consultant Stanford University Medical Director, Hepatitis B Foundation Singapore Viral Hepatitis Meeting 2014 1 Disclosures Dr
More informationConsiderations for Antiretroviral Use in Patients with Hepatitis B Virus & Human Immunodeficiency Syndrome Coinfection
Considerations for Antiretroviral Use in Patients with Hepatitis B Virus & Human Immunodeficiency Syndrome Coinfection Mahnaz Arian, MD Assistant Professor in infectious Disease Mashhad university of Medical
More informationHBV in HIV Forgotten but not Gone
Activity Code FA376 HBV in HIV Forgotten but not Gone Richard K. Sterling, MD, MSc VCU Hepatology Professor of Medicine Chief, Section of Hepatology Virginia Commonwealth University Learning Objectives
More informationEmerging Challenges In Primary Care: Chronic Hepatitis B: Guidelines for Screening, Clinical Management, Whether to Follow or Treat, and How
Emerging Challenges In Primary Care: 2015 Chronic Hepatitis B: Guidelines for Screening, Clinical Management, Whether to Follow or Treat, and How 1 Faculty Christopher O'Brien, MD, AGAF, FRCMI Professor
More informationHepatitis B Update. Jorge L. Herrera, M.D. University of South Alabama Mobile, AL. Gastroenterology
Hepatitis B Update Jorge L. Herrera, M.D. University of South Alabama Mobile, AL Deciding Who to Treat Is hepatitis B a viral disease or a liver disease? Importance of HBV-DNA Levels in the Natural History
More informationViral hepatitis in reproductive health. Pierre Jean Malè. Training in Reproductive Health Research - Geneva 2006
Viral hepatitis in reproductive health Pierre Jean Malè Training in Reproductive Health Research - Geneva 2006 15.03.2006 HBV and HCV treatment Pierre-Jean Malè MD 15.03.2006 Global Impact of Hepatitis
More informationIs there a need for combination treatment? Yes!
18.0.2012 C Hep Meeting Berlin Is there a need for combination treatment? Yes! Florian van Bömmel University Hospital Leipzig Hepatology Section Germany Most patients respond to monotherapy with entecavir
More informationHepatitis B and D Update on clinical aspects
Hepatitis B and D Update on clinical aspects B. Müllhaupt Gastroenterology and Hepatology Swiss Transplant and HPB-Center University Hospital Zurich beat.muellhaupt@usz.ch B.M. 11.11.17 Hepatitis Strategy
More informationA Message to Presenters
A Message to Presenters As a healthcare professional speaking on behalf of Bristol-Myers Squibb (BMS), any presentation you make on our behalf must be consistent with the current FDA-approved product labeling
More informationTreatment of chronic hepatitis B 2013 update
22 February 213 Treatment of chronic hepatitis B 213 update Pietro Lampertico 1st Gastroenterology Unit Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico Università di Milano EASL 212 Clinical
More informationEmerging Challenges In Primary Care: 2015
Emerging Challenges In Primary Care: 2015 Chronic Hepatitis B: Guidelines for Screening, Clinical Management, Whether to Follow or Treat, 1 Faculty Christopher O'Brien, MD, AGAF, FRCMI Professor of Clinical
More informationManagement of Hepatitis B - Information for primary care providers
Management of Hepatitis B - Information for primary care providers July 2018 Chronic hepatitis B (CHB) is often a lifelong condition. Not everyone infected needs anti-viral therapy. This document outlines
More informationEmerging Challenges In Primary Care: 2015
Emerging Challenges In Primary Care: 2015 Chronic Hepatitis B: Guidelines for Screening, Clinical Management, Whether to Follow or Treat, 1 Faculty Christopher O'Brien, MD, AGAF, FRCMI Professor of Clinical
More informationNovedades en el tratamiento de la hepatitis B: noticias desde la EASL. Maria Buti Hospital Universitario Valle Hebrón Barcelona
Novedades en el tratamiento de la hepatitis B: noticias desde la EASL Maria Buti Hospital Universitario Valle Hebrón Barcelona Milestones in CHB treatment Conventional IFN 1991 Lamivudine (LAM) 1998 Adefovir
More informationManagement of hepatitis B virus
Journal of Antimicrobial Chemotherapy Advance Access published May 14, 2008 Journal of Antimicrobial Chemotherapy doi:10.1093/jac/dkn188 Management of hepatitis B virus Nidhi A. Singh and Nancy Reau* Section
More informationHow to use pegylated Interferon for Chronic Hepatitis B in 2015
How to use pegylated Interferon for Chronic Hepatitis B in 215 Teerha Piratvisuth NKC Institute of Gastroenterology and Hepatology Prince of Songkla University, Thailand ASIAN-PACIFIC CLINICAL PRACTICE
More informationHepatitis B virus infection (HBV) is global epidemic. Current Treatment Strategies for the Management of Chronic Hepatitis B CHRONIC HEPATITIS B
CHRONIC HEPATITIS B Current Treatment Strategies for the Management of Chronic Hepatitis B Case Study and Commentary, Robert J. Wong, MD, and Walid S. Ayoub, MD ABSTRACT Objective: To review current treatment
More informationThe role of entecavir in the treatment of chronic hepatitis B
REVIEW The role of entecavir in the treatment of chronic hepatitis B Evangelini Dimou Vasilios Papadimitropoulos Stephanos J Hadziyannis Department of Medicine and Liver Unit, Henry Dunant Hospital, Athens,
More informationTreatment of hepatitis B
Treatment of hepatitis B Prof. Dr. Cihan Yurdaydin University of Ankara Medical School Department of Gastroenterology 2 nd CEE Meeting on Viral Hepatitis and Co-infection with HIV Bucharest, Romania, 6-7
More informationChoice of Oral Drug for Hepatitis B: Status Asokananda Konar
Choice of Oral Drug for Hepatitis B: Status 2011 Asokananda Konar Chronic hepatitis B (CHB) is a global public health challenge with an estimated 350 to 400 million people with chronic HBV infection, despite
More informationEASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection
EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection European Association for the Study of the Liver Introduction Our understanding of the natural history of hepatitis B
More informationNew therapeutic perspectives in HBV: when to stop NAs
Liver International ISSN 1478-3223 REVIEW ARTICLE New therapeutic perspectives in HBV: when to stop NAs Cristina Perez-Cameo, Monica Pons and Rafael Esteban Liver Unit, Department of Internal Medicine,
More informationHorizon Scanning Technology Summary. Tenofovir disoproxil fumarate for hepatitis B. National Horizon Scanning Centre. April 2007
Horizon Scanning Technology Summary National Horizon Scanning Centre Tenofovir disoproxil fumarate for hepatitis B April 2007 This technology summary is based on information available at the time of research
More informationCurrent Status of HBV and Liver Transplant
Current Status of HBV and Liver HBV as Indication for Liver ation in U.S. Significant decrease in rate of wait listing for decompensated cirrhosis since 2003 (since s) No change in rate of wait listing
More informationIntron A Hepatitis B. Intron A (interferon alfa-2b) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.01.01 Subject: Intron A Hepatitis B Page: 1 of 7 Last Review Date: November 30, 2018 Intron A Hepatitis
More informationtenofovir disoproxil (as fumarate), 245mg, film-coated tablet (Viread ) SMC No. (720/11) Gilead Sciences Ltd
tenofovir disoproxil (as fumarate), 245mg, film-coated tablet (Viread ) SMC No. (720/11) Gilead Sciences Ltd 05 August 2011 The Scottish Medicines Consortium (SMC) has completed its assessment of the above
More informationThe advent of sensitive assays for the detection of hepatitis
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2013;-:1 10 All studies published in Clinical Gastroenterology and Hepatology are embargoed until 3PM ET of the day they are published as corrected proofs on-line.
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice SCOPE Clinical guideline title: Hepatitis B (chronic): diagnosis and management of chronic hepatitis B in children, young
More informationHepatitis B: A Preventable Cause of Liver Cancer. Saira Khaderi MD, MPH Assistant Professor of Surgery Associate Director, Project ECHO June 17, 2016
Hepatitis B: A Preventable Cause of Liver Cancer Saira Khaderi MD, MPH Assistant Professor of Surgery Associate Director, Project ECHO June 17, 2016 Overview Epidemiology HBV and cancer Screening, Diagnosis
More informationDr David Rowbotham NHS. The Leeds Teaching Hospitals. NHS Trust
Dr David Rowbotham The Leeds Teaching Hospitals NHS Trust NHS Nurses Update June 2010 Chronic Hepatitis HBV / HCV David Rowbotham Clinical Director & Consultant Gastroenterologist Dept of Gastroenterology
More informationViral Hepatitis. Dr Melissa Haines Gastroenterologist Waikato Hospital
Viral Hepatitis Dr Melissa Haines Gastroenterologist Waikato Hospital Viral Hepatitis HAV HBV HCV HDV HEV Other viral: CMV, EBV, HSV Unknown Hepatitis A Hepatitis A Transmitted via the faecal-oral route
More informationScottish Medicines Consortium
Scottish Medicines Consortium tenofovir disoproxil (as fumarate), 245 mg film-coated tablet (Viread ) No. (479/08) Gilead Sciences 06 June 2008 The Scottish Medicines Consortium has completed its assessment
More informationHow find a solution for alternative to indefinite nucleoside analogue therapy in patients chronic HBV infection?
How find a solution for alternative to indefinite nucleoside analogue therapy in patients chronic HBV infection? Philippe Halfon, MD,PhD Associate Professor of Medicine Hôpital Europeen Marseille, France
More informationOutline. Updates in the Clinical Management of Hepatitis B and C. Who should be screened for HBV? Chronic Hepatitis B 10/7/2018
Outline Updates in the Clinical Management of Hepatitis B and C Jennifer C. Lai, MD, MBA Transplant Hepatologist Associate Professor of Medicine In Residence University of California, San Francisco Initial
More informationManagement of Hepatitis B & HIV Coinfection: A Clinical Update. Douglas G. Fish, MD Albany Medical College Cali, Colombia March 14, 2008
Management of Hepatitis B & HIV Coinfection: A Clinical Update Douglas G. Fish, MD Albany Medical College Cali, Colombia March 14, 2008 In patients with HIV/HBV co-infection who are HBcoreAb(IgG + IgM)
More informationGilead Sciences, Durham, NC, USA
Tenofovir Disoproxil Fumarate (TDF) Versus Emtricitabine Plus TDF () for Treatment of Chronic Hepatitis B (CHB) In Patients with Persistent Viral Replication Receiving Adefovir Dipivoxil: Final Week 168
More informationTerapia dell epatite cronica B: paradigmi attuali e possibili scenari futuri
Terapia dell epatite cronica B: paradigmi attuali e possibili scenari futuri Nicola Coppola Dipartimento di Salute Mentale e Medicina Preventiva Seconda Università di Napoli Main goal of treatment of chronic
More informationMutazioni di HBV in corso di trattamento; quale approccio razionale?
Mutazioni di HBV in corso di trattamento; quale approccio razionale? Prevenire Interpretare Trattare Marco Lagget UODU Gastroenterologia ed Epatologia AOU San Giovanni Battista di Torino Prevenire 1) Timing
More informationClinical dilemmas in HBeAg-negative CHB
Clinical dilemmas in HBeAg-negative CHB George V. Papatheodoridis Professor in Medicine & Gastroenterology Medical School of National & Kapodistrian University of Athens Director of Academic Department
More informationHepatitis B screening and surveillance in primary care
Hepatitis B screening and surveillance in primary care Catherine Stedman Associate Professor of Medicine, University of Otago, Christchurch Gastroenterology Department, Christchurch Hospital Disclosures
More informationResponse-guided antiviral therapy in chronic hepatitis B: nucleot(s)ide analogues vs. pegylated interferon
Response-guided antiviral therapy in chronic hepatitis B: Sang Hoon Ahn, M.D., Ph.D. Department of Internal Medicine, Yonsei University College of Medicine, Institute of Gastroenterology, Liver Cirrhosis
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice SCOPE Clinical guideline title: Hepatitis B (chronic): diagnosis and management of chronic hepatitis B in children, young
More informationTreatment Op+ons for Chronic Hepa++s B. Judith Feinberg, MD Project ECHO Jan. 19, 2017
Treatment Op+ons for Chronic Hepa++s B Judith Feinberg, MD Project ECHO Jan. 19, 2017 Treatment of Chronic Hepatitis B can be prevented by vaccinacon (part of infant series since 1992-3) goal of drug therapy
More informationPrediction of HBsAg Loss by Quantitative HBsAg Kinetics during Long-Term 2015
THAI J 16 GASTROENTEROL Treatment with Nucleos(t)ide Original Analogues Article Prediction of HBsAg Loss by Quantitative HBsAg Kinetics during Long-Term Treatment with Nucleos(t)ide Analogues Sombutsook
More information