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International Journal of Hepatology
Volume 2011, Article ID 918017, 11 pages
http://dx.doi.org/10.4061/2011/918017
Review Article

Treatment of Hepatitis B in Decompensated Liver Cirrhosis

1Mount Elizabeth Hospital and Medical Centre, Singapore 228510
2Gleneagles Hospital and Medical Centre, Singapore 258500

Received 15 February 2011; Accepted 19 April 2011

Academic Editor: Deepak Amarapurkar

Copyright © 2011 Richard Guan and Hock Foong Lui. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronic hepatitis B infection progresses from an asymptomatic persistently infected state to chronic hepatitis, cirrhosis, decompensated liver disease, and/or hepatocellular carcinoma. About 3% of patients with chronic hepatitis develop cirrhosis yearly, and about 5% of individuals with hepatitis B cirrhosis become decompensated annually. The outcome for patients with decompensated cirrhosis is bleak. Lamivudine, the first oral antiviral agent available for hepatitis B treatment is safe and effective and can improve or stabilize liver disease in patients with advanced cirrhosis and viraemia. Viral resistance restricts its prolonged use. Entecavir and tenofovir are newer agents with excellent resistance profile to date. These and some other antiviral agents are being investigated for optimal use in this rather challenging patient group.