Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection

Overview

These are the first World Health Organization (WHO) guidelines for the prevention, care and treatment of persons living with chronic hepatitis B (CHB) infection, and complement similar recently published guidance by WHO on the prevention, care and treatment of infection due to the hepatitis C virus (HCV).

The recommendations in these guidelines promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of nucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which will be updated in 2015.

These recommendations provide opportunities to save lives, improve clinical outcomes of persons living with CHB, reduce HBV incidence and transmission, and stigma due to disease, but they also pose practical challenges to policymakers and implementers in low- and middle-income countries.