title: Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update.
abstract: Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India. shivsarin@gmail.com.
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authors.initials: SK
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authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
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authors.affiliation: Division of Gastroenterology and Hepatology, Humanity and Health Medical Centre, Hong Kong SAR, China.|The Institute of Translational Hepatology, Beijing, China.
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authors.affiliation: Department of Hepatogastroenterlogy, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
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authors.affiliation: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
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authors.affiliation: Genomics Research Center, Academia Sinica, National Taiwan University, Taipei, Taiwan.
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authors.affiliation: Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
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authors.affiliation: Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
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authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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authors.affiliation: Liver Research Unit, Chang Gung Memorial Hospital and University, Chilung, Taiwan.
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authors.affiliation: Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
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authors.affiliation: Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Guangzhou, China.
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authors.affiliation: Department of Medicine, Aga Khan University, Karachi, Pakistan.
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authors.affiliation: Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong, China.
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authors.affiliation: Internal Medicine Asan Medical Center, Seoul, Korea.
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authors.affiliation: Division of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore.
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authors.affiliation: Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
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authors.affiliation: Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
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authors.lastname: Al Mahtab
authors.affiliation: Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: R
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authors.affiliation: Yamanashi Hospitals (Central and Kita) Organization, 1-1-1 Fujimi, Kofu-shi, Yamanashi, 400-8506, Japan.
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authors.affiliation: NKC Institute of Gastroenterology and Hepatology, Prince of Songkla University, Songkhla, Thailand.
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authors.lastname: Piratvisuth
authors.affiliation: Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India.
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authors.lastname: Sharma
authors.affiliation: Department of Medicine, University of Santo Tomas, Manila, Philippines.
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authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: F S
authors.initials: FS
authors.lastname: Wang
authors.affiliation: Peking University Hepatology Institute, Beijing, China.
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authors.lastname: Wei
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Pofulam, Hong Kong.
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authors.initials: MF
authors.lastname: Yuen
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, China.
authors.forename: S S
authors.initials: SS
authors.lastname: Zheng
authors.affiliation: Graduate Institute of Clinical Medicine and Hepatitis Research Center, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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mesh_terms: D000208:Acute Disease; D000349:Africa; D000998:Antiviral Agents / Q000627:therapeutic use; D001208:Asia; D019468:Disease Management; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis* / Q000628:therapy*; D006515:Hepatitis B virus / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male
chemical_list: D000998:Antiviral Agents
keywords: Acute hepatitis; Guidelines; HBV