title: New advances in chronic hepatitis B.
abstract: OBJECTIVE
  This article reviews recent developments in the evaluation and treatment of chronic hepatitis B (CHB) based on articles published between December 2010 and January 2012.
  
  
  RESULTS
  The majority of patients infected with CHB have not been diagnosed and most at-risk individuals have not been immunized. Progression to cirrhosis depends on hepatitis B virus (HBV) genotype, hepatitis B e antigen (HBeAg) presence, persistently high levels of HBV DNA, and elevated alanine aminotransferase, although hepatitis B surface antigen (HBsAg) kinetics may help predict natural history and antiviral response. Antiviral resistance limits the success of nucleos(t)ide analogs and agents such as entecavir and tenofovir with high potency and high genetic barrier to resistance are considered first-line therapy. Specialized treatment of CHB in pregnancy, coinfection, decompensated cirrhosis, and posttransplant is safe and effective.
  
  
  CONCLUSIONS
  The complications of CHB can now be avoided and reversed with potent antiviral suppression of HBV DNA. For now, treatment is long-term and further studies are needed to discern whether sequential or combination therapy may be superior to current monotherapy for certain patients. Increased awareness should improve screening resulting in more frequent treatment and immunization of at-risk individuals toward eventual CHB eradication.
authors.affiliation: Division of Digestive and Liver Disease, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75390–8887, USA. Shannan.Tujios@UTSouthwestern.edu
authors.forename: Shannan R
authors.initials: SR
authors.lastname: Tujios
authors.forename: William M
authors.initials: WM
authors.lastname: Lee
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000998:Antiviral Agents / Q000008:administration & dosage; D060085:Coinfection; D018450:Disease Progression; D024882:Drug Resistance, Viral; D005260:Female; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D017408:Guidelines as Topic; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control / Q000821:virology; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D003699:Hepatitis D / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007372:Interferons / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000821:virology; D063065:Organophosphonates / Q000008:administration & dosage; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000517:prevention & control / Q000821:virology; D012307:Risk Factors; D000068698:Tenofovir
chemical_list: D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D063065:Organophosphonates; C413685:entecavir; D006147:Guanine; D007372:Interferons; D000068698:Tenofovir; D000225:Adenine