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Review
. 2019 Jun;25(2):93-159.
doi: 10.3350/cmh.2019.1002. Epub 2019 Jun 12.

KASL clinical practice guidelines for management of chronic hepatitis B

Korean Association for the Study of the Liver (KASL)
Review

KASL clinical practice guidelines for management of chronic hepatitis B

Korean Association for the Study of the Liver (KASL). Clin Mol Hepatol. 2019 Jun.
No abstract available

Keywords: Chronic hepatitis B; KASL guidelines; Treatment.

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Conflict of interest statement

Conflicts of Interest

Yim HJ: Received honoraria from Gilead, Yuhan, and Chongkundang Pharm. Received grants from Dong-A ST, Chongkundang Pharm, and Gilead.

Yoon EL: Received honoraria, consulted for, and received grant from Samil.

Kim JH: Received honoraria from Gilead, Abbvie, Chong kundang, Yuhan, Dong-A ST. Consulted for Gilead, Abbvie, Chongkundang, Dong-A ST. Received grants from Gilead, BMS, Abbvie, Chongkundang, Yuhan, Dong-A ST, Daewoong, Samjin, and KOWA.

Sinn DH: Received honoraria from Gilead, and Dong-A ST. Received grant from Dong-A ST.

Lee HW: Received honoraria from Gilead, Abbvie, Chongkundang, Yuhan, Dong-A ST, and Ildong.

Park JY: Received honoraria from Gilead, Yuhan, Abbvie, DongA ST, Hanmi, and Chongkundang. Received grants from Samil, Abbvie, Gilead, and Norvatis.

Lee JH: Nothing to declare.

Kwon JH: Received honoraria for lectures and consultation from Gilead, Abbvie, MSD, and BMS.

Park H: Received honoraria from Gilead. Received grants from Daewoong.

Yim HJ: Received honoraria from Gilead, Yuhan, and Chongkundang Pharm. Received grants from Dong-A ST, Chongkundang Pharm, and Gilead.

Figures

Figure 1.
Figure 1.
Natural course of chronic hepatitis B. Serological, virological, and biochemical characteristics during five phases of chronic hepatitis B are depicted (modified from Yim et al. [17]. Inflammatory activity may vary from minimal (-), mild (+), or moderate (++) to severe (+++). HBsAg, hepatitis B surface antigen; Anti-HBs, antibody to hepatitis B surface antigen; HBeAg, hepatitis B e antigen; Anti-HBe, antibody to hepatitis B e antigen; HBV, hepatitis B virus; ALT, alanine aminotransferase; CHB, chronic hepatitis B.
Figure 2.
Figure 2.
Algorithm for management of chronic hepatitis B virus (HBV) infection. Initiation of antiviral therapy should be determined considering severity of liver disease, degree of HBV replication, and presence of liver injury. HBsAg, hepatitis B surface antigen; HBeAg, hepatitis B e antigen; anti-HBe, antibody to hepatitis B e antigen; AST, aspartate aminotransferase; ALT, alanine aminotransferase.
Figure 3.
Figure 3.
On-treatment management of patients receiving nucleos(t)ide analogues. Appropriate monitoring is required for the proper management at given situations. HBV, hepatitis B virus; LFT, liver function test; HBeAg, hepatitis B e antigen; anti-HBe, antibody to hepatitis B e antigen; HBsAg, hepatitis B surface antigen; CK, creatine phosphokinase; HCC, hepatocellular carcinoma; tenofovir DF, tenofovir disoproxil fumarate.
Figure 4.
Figure 4.
Indications for selecting entecavir, tenofovir alafenamide fumarate, or besifovir over tenofovir disoproxil fumarate. Concomitant comorbidities and past history of antiviral treatment should be considered for choosing nculeos(t)ide analogues (modified from European Association for the Study of the Liver97). Tenofovir AF, tenofovir alafenamide fumarate. *In case of history of antiviral resistance, refer to Table 9; †Entecavir needs dose adjustments if creatinine clearance <50 mL/min, refer to Table 10; ‡Not indicated if creatinine clearance <15 mL/min; §Not indicated if creatinine clearance <50 mL/min.
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