title: [Diagnosis and treatment of chronic hepatitis B and D. Hungarian national consensus guideline].
abstract: Diagnosis and treatment of hepatitis B and D virus infections mean that the patient is able to maintain working capacity, increase quality of life, prevent cancer, and prolong life expectancy, while the society benefits from eliminating the chances of further transmission of the viruses, and decreasing the overall costs of serious complications. The guideline delineates the treatment algorithms for 2014, which is agreed on a consensus meeting of specialists involved in the treatment of the above diseases. The prevalence of hepatitis B virus infection in the Hungarian general population is 0.5-0.7%. The indications of treatment is based upon viral examinations (including viral nucleic acid determination), determinations of disease activity and stage (including biochemical, pathologic, and/or non-invasive methods), and excluding contraindications. To avoid unnecessary side effects and for cost-effective approach the guideline emphasizes the importance of quick and detailed virologic evaluations, the applicability of transient elastography as an acceptable alternative of liver biopsy in this regard, as well as the relevance of appropriate consistent follow up schedule for viral response during therapy. The first choice of therapy in chronic hepatitis B infection can be pegylated interferon for 48 weeks or continuous entecavir or tenofovir therapy. The latter two must be continued for at least 12 months after hepatitis B surface antigen seroconversion. Adefovir dipivoxil is recommended mainly in combination therapy. Lamivudine is no longer a first choice; patients currently taking lamivudine must switch if response is inadequate. Appropriate treatment of patients taking immunosuppressive medications is highly recommended. Pegylated interferon based therapy is recommended for the treatment of concomitant hepatitis D infection.
authors.affiliation: Budai Hepatológiai Centrum Budapest Egry József u. 1-3. 1111 Szent János Kórház és Észak-budai Egyesített Kórházak Hepatológiai Szakambulancia Budapest.
authors.forename: Gábor
authors.initials: G
authors.lastname: Horváth
authors.affiliation: Somogy Megyei Kaposi Mór Oktató Kórház Belgyógyászati Osztály Kaposvár Pécsi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Pécs.
authors.forename: Béla
authors.initials: B
authors.lastname: Hunyady
authors.affiliation: Szent György Egyetemi Oktató Kórház I. Belgyógyászat és Molekuláris Diagnosztikai Laboratórium Székesfehérvár.
authors.forename: Judit
authors.initials: J
authors.lastname: Gervain
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Lengyel
authors.affiliation: Egyesített Szent István és Szent László Kórház Budapest.
authors.forename: Mihály
authors.initials: M
authors.lastname: Makara
authors.affiliation: Pécsi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Pécs.
authors.forename: Alajos
authors.initials: A
authors.lastname: Pár
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Budapest.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Szalay
authors.affiliation: Egyesített Szent István és Szent László Kórház Budapest.
authors.forename: László
authors.initials: L
authors.lastname: Telegdy
authors.affiliation: Debreceni Egyetem, Általános Orvostudományi Kar, Orvos- és Egészségtudományi Centrum Belgyógyászati Intézet Debrecen.
authors.forename: István
authors.initials: I
authors.lastname: Tornai
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D032921:Consensus; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D019701:Hepatitis D, Chronic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D003698:Hepatitis Delta Virus / Q000302:isolation & purification*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000517:prevention & control; D063065:Organophosphonates / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D000068698:Tenofovir
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D063065:Organophosphonates; D011994:Recombinant Proteins; D019259:Lamivudine; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000068698:Tenofovir; D000225:Adenine; C100416:peginterferon alfa-2a
keywords: adefovir; cirrhosis; entecavir; hepatitis B virus; hepatitis B-vírus; hepatitis D virus; hepatitis D-vírus; interferon; lamivudin; lamivudine; liver cancer; májrák; májzsugor; pegilált interferon; pegylated interferon; tenofovir; viral hepatitis; vírushepatitis