Management of hepatitis B and C in special population

World J Gastroenterol. 2021 Oct 28;27(40):6861-6873. doi: 10.3748/wjg.v27.i40.6861.

Abstract

Chronic viral hepatitis is one of the leading causes of cirrhosis worldwide. Chronic hepatitis B is more common in the Asia-Pacific region due to the larger population and lower screening availability. Hepatitis C predominates in the west due to injection drug abuse. The discovery of (oral) direct-acting antiviral agents (DAAs) has changed the landscape of chronic hepatitis C (CHC) management. Nucleos(t)ide analogs (NUCs) have also changed the approach to the treatment of chronic hepatitis B (CHB). Oral NUCs and DAAs have excellent efficacy and patient acceptance as well as a lower risk of resistance. However, certain populations have no robust data and safety and efficacy of such oral drugs is still evolving. In this review, we provide an overview of the management of CHB and CHC in special populations, such as those with chronic kidney disease, pregnant women, healthcare workers, and those undergoing chemo- or immunosuppressive therapy.

Keywords: Chronic kidney disease; Health care professionals; Hepatitis B; Hepatitis C; Pregnancy; Tenofovir.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / adverse effects
  • Female
  • Hepatitis B e Antigens
  • Hepatitis B virus / genetics
  • Hepatitis B* / drug therapy
  • Hepatitis B, Chronic* / diagnosis
  • Hepatitis B, Chronic* / drug therapy
  • Hepatitis B, Chronic* / epidemiology
  • Hepatitis C, Chronic* / diagnosis
  • Hepatitis C, Chronic* / drug therapy
  • Hepatitis C, Chronic* / epidemiology
  • Humans
  • Pregnancy
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Hepatitis B e Antigens