Expanding indications for chronic hepatitis B treatment: Is it really desirable to treat everyone?

Abstract

Chronic viral hepatitis causes an increased risk of progressive liver disease and hepatocellular carcinoma. On the wave of the World Health Organization’s goal to reduce new cases and deaths from hepatitis B and C by 2030, there is an increasing call to expand the indications for treatment of chronic hepatitis B. Currently, the main goal of treatment is to achieve a functional cure due to the inability of current drugs to completely eradicate the virus. There are still many discrepancies between available guidelines in terms of eligibility for treatment as well as an uncertainty about the appropriate treatment duration. This editorial addresses key questions about the topic and whether indications for treatment should be expanded.

Keywords: Hepatitis B virus; Interferon; Nucleos(t)ide analogues; Functional cure; Children

Core Tip: There is a growing trend to expand the indications for the treatment of chronic hepatitis B. Starting from the concept that current therapies for chronic hepatitis B are unable to completely eradicate hepatitis B virus infection, this editorial critically analyzes the long-term efficacy of the available therapies and the rationale for an extension of current indications.