Alignment of countries in the Americas with the latest WHO guidelines for hepatitis B virus (HBV) infection: a review

Summary: Evidence is lacking on alignment of current guidance from the Region of the Americas (AMR) countries with the new guidelines for people with hepatitis B virus (HBV) infection published by the World Health Organization (WHO) in March 2024. We gathered the most updated guidance on HBV infecti...

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Main Authors: Hugo Perazzo, Estevão Portela Nunes, Sandra W. Cardoso, Valdilea G. Veloso, Beatriz Grinsztejn
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:The Lancet Regional Health. Americas
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667193X24002527
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author Hugo Perazzo
Estevão Portela Nunes
Sandra W. Cardoso
Valdilea G. Veloso
Beatriz Grinsztejn
author_facet Hugo Perazzo
Estevão Portela Nunes
Sandra W. Cardoso
Valdilea G. Veloso
Beatriz Grinsztejn
author_sort Hugo Perazzo
collection DOAJ
description Summary: Evidence is lacking on alignment of current guidance from the Region of the Americas (AMR) countries with the new guidelines for people with hepatitis B virus (HBV) infection published by the World Health Organization (WHO) in March 2024. We gathered the most updated guidance on HBV infection from organisations/societies and seven countries from AMR. Most guidelines were aligned with the new WHO recommendation to treat persons with elevated ALT and HBV-DNA levels ≥2,000 IU/ml or with HIV-coinfection, hepatocellular carcinoma family history, extra-hepatic manifestations, or immunosuppression. The new WHO 2024 guidelines introduced treatment for persistently abnormal ALT in the absence of HBV-DNA, with TDF and/or entecavir as first-line therapy. TDF in pregnant women with high HBV-DNA levels was recommended to prevent mother-to-child transmission (MTCT). These guidelines advised prophylaxis to pregnant women with positive HBsAg where HBV-DNA is unavailable. WHO 2024 and updated guidelines from most AMR countries had simplified and expanded criteria for HBV treatment and MTCT prevention.
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series The Lancet Regional Health. Americas
spelling doaj-art-ba85d7ea312d495a9cae900ba563cc322025-08-20T02:14:51ZengElsevierThe Lancet Regional Health. Americas2667-193X2024-11-013910092510.1016/j.lana.2024.100925Alignment of countries in the Americas with the latest WHO guidelines for hepatitis B virus (HBV) infection: a reviewHugo Perazzo0Estevão Portela Nunes1Sandra W. Cardoso2Valdilea G. Veloso3Beatriz Grinsztejn4Corresponding author. LAPCLIN-AIDS – INI/FIOCRUZ, Av. Brasil, 4365 - CEP, Rio de Janeiro 21040-360, Brazil.; Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, BrazilEvandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, BrazilEvandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, BrazilEvandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, BrazilEvandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, BrazilSummary: Evidence is lacking on alignment of current guidance from the Region of the Americas (AMR) countries with the new guidelines for people with hepatitis B virus (HBV) infection published by the World Health Organization (WHO) in March 2024. We gathered the most updated guidance on HBV infection from organisations/societies and seven countries from AMR. Most guidelines were aligned with the new WHO recommendation to treat persons with elevated ALT and HBV-DNA levels ≥2,000 IU/ml or with HIV-coinfection, hepatocellular carcinoma family history, extra-hepatic manifestations, or immunosuppression. The new WHO 2024 guidelines introduced treatment for persistently abnormal ALT in the absence of HBV-DNA, with TDF and/or entecavir as first-line therapy. TDF in pregnant women with high HBV-DNA levels was recommended to prevent mother-to-child transmission (MTCT). These guidelines advised prophylaxis to pregnant women with positive HBsAg where HBV-DNA is unavailable. WHO 2024 and updated guidelines from most AMR countries had simplified and expanded criteria for HBV treatment and MTCT prevention.http://www.sciencedirect.com/science/article/pii/S2667193X24002527Hepatitis BTreatmentMother to child transmissionNon-invasive testsGuidelines
spellingShingle Hugo Perazzo
Estevão Portela Nunes
Sandra W. Cardoso
Valdilea G. Veloso
Beatriz Grinsztejn
Alignment of countries in the Americas with the latest WHO guidelines for hepatitis B virus (HBV) infection: a review
The Lancet Regional Health. Americas
Hepatitis B
Treatment
Mother to child transmission
Non-invasive tests
Guidelines
title Alignment of countries in the Americas with the latest WHO guidelines for hepatitis B virus (HBV) infection: a review
title_full Alignment of countries in the Americas with the latest WHO guidelines for hepatitis B virus (HBV) infection: a review
title_fullStr Alignment of countries in the Americas with the latest WHO guidelines for hepatitis B virus (HBV) infection: a review
title_full_unstemmed Alignment of countries in the Americas with the latest WHO guidelines for hepatitis B virus (HBV) infection: a review
title_short Alignment of countries in the Americas with the latest WHO guidelines for hepatitis B virus (HBV) infection: a review
title_sort alignment of countries in the americas with the latest who guidelines for hepatitis b virus hbv infection a review
topic Hepatitis B
Treatment
Mother to child transmission
Non-invasive tests
Guidelines
url http://www.sciencedirect.com/science/article/pii/S2667193X24002527
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