Clinical Gastroenterology Vol.24 No.6(2-1)

Theme Cutting Edge : Pathogenesis and Treatment of Hepatitis B
Title Guideline for Treatment of Patients Infected with Hepatitis B Virus in Japan
Publish Date 2009/06
Author Hiromitsu Kumada Toranomon Hospital
[ Summary ] Generally, young patients with hepatitis B e antigen (HBeAg) tend to follow up without any treatments owing to highly natural seroclearance of HBeAg. Thus, Japanese Guidelines for the treatment of chronic hepatitis B are divided into two parts based on the difference of age.
2008 Guidelines of treatment for chronic hepatitis B showed that patients should be treated based on difference of age and serum level of HBV DNA. According to 2008 Guidelines, the change items compared to the 2007 Guidelines are the following three point. 1) HBeAg negative patients with <35 years old and serum HBV DNA level of ≥7 log copies/ml should be given the sequential therapy of entecavir and interferon as the first selection. This therapy has the possibility of stopping the administration of entecavir. 2) HBeAg negative patients who have platelet count of <150,000/mm3 and advanced stage of F2, F3, F4 in patients with <35 years old should be given for protecting the development of hepatocellular carcinoma. 3) HBeAg negative patients with ≥35 years old and serum HBV DNA level of <7 log copies/ml should be permitted the prolonged interferon therapy.
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