title: Management of HBV and HBV/HDV-Associated Liver Cirrhosis.
abstract: BACKGROUND
  Chronic hepatitis B virus (HBV) infection and hepatitis delta virus (HDV) co-infection lead to liver cirrhosis, hepatic decompensation, and hepatocellular carcinoma (HCC).
  
  
  METHODS
  We review the current knowledge of the management of HBV mono-infection and HBV/HDV co-infection with a special emphasis on liver cirrhosis.
  
  
  RESULTS
  Treatment options for chronic hepatitis B are pegylated interferon (PEG-IFN) alfa and nucleos(t)ide analogues (NUC). PEG-IFN is a finite option to achieve hepatitis B surface antigen loss in compensated cirrhosis. However, this goal is rare. NUC are potent to achieve HBV DNA suppression but long-term treatment is mandatory in most cases. Long-term treatment with NUC can lead to reversion of liver cirrhosis, improve liver function, prevent liver transplantation, and reduces but does not eliminate the risk for development of HCC. Treatment options for hepatitis D are limited to PEG-IFN. Although late relapse is common, treatment with PEG-IFN reduces disease progression. However, new treatments are urgently needed for HDV infection.
  
  
  CONCLUSIONS
  Early treatment of chronic hepatitis B and D is important to prevent complications of cirrhosis. HCC surveillance remains important in patients with cirrhosis.
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Medical School Hannover, Hanover, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Höner Zu Siederdissen
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Medical School Hannover, Hanover, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Cornberg
keywords: HCC; Hepatitis B; Hepatitis D; Hepatocellular carcinoma; Liver cirrhosis; Nucleos(t)ide analogues; Pegylated interferon