The Liver Meeting 2020-Hepatitis B SIG HBV: Current Management Controversies and the Road to a Cure

Video Transcription

Video Summary

The video discusses managing chronic hepatitis B in older patients, focusing on comorbidities like renal insufficiency, osteoporosis, metabolic diseases, and NAFLD. Screening for renal function and osteoporosis is emphasized for older hepatitis B patients on long-term antiviral therapy. The concept of MAFLD for diagnosing liver disease in patients with metabolic dysregulation is introduced, along with the impact of having both hepatitis B and NAFLD on liver complications. Screening, surveillance, and multidisciplinary management strategies for dual liver diseases are recommended for better outcomes. Challenges in managing these complex liver diseases in older patients are highlighted. <br /><br />In a systematic review, no significant association between steatosis and increased fibrosis was found among over 33,000 patients, differing from analyses focusing on NASH. Antiviral therapy responses were similar in patients with and without fatty liver, but long-term outcomes showed increased risks of cirrhosis and HCC in those with fatty liver disease. Fatty liver in patients with hepatitis B on antiviral therapy was associated with lower risks of cirrhosis and HCC. Therapeutic strategies for hepatitis B cure involve stimulating innate immunity, blocking immunosuppressive pathways, and producing neutralizing antibodies. Combination therapies with antivirals and immune modifiers showed promising results in reducing viral load and antigens for potential functional cure, requiring personalized treatment approaches for improved outcomes while balancing efficacy and safety considerations.

Keywords

Chronic hepatitis B

Older patients

Comorbidities

Renal insufficiency

Osteoporosis

Metabolic diseases

NAFLD

Screening

Antiviral therapy

MAFLD

Liver complications

Dual liver diseases