VIDEO: Patients in HBV viral ‘gray zone’ may benefit from treatment
SAN ANTONIO — In this exclusive video from the National Liver Conference 2019, Robert S. Brown, MD, from the Weill Cornell Medical Center, examines “who to treat” among patients with hepatitis B based on a panel discussion from the meeting.
Brown explained that this includes patients in the so-called “gray zone” who have either an HBV DNA viral load just above 2,000 but normal alanine aminotransferase levels or abnormal ALT with a viral load below 2,000.
“These have been perplexing patients in my practice,” he said. “We know they’re at risk for progressive disease, yet they don’t meet our guidelines for treatment.”
During the panel, Brown and colleagues reviewed the risks for liver cancer associated with viral genotype, patient sex and family history, along with which patients may justifiably require earlier treatment.
“We also saw that many of those patients will progress to active disease in the near future and just how many of those patients there are,” he said. “I’m going to spend time in the coming months when I see patients with HBV in my practice discussing how to manage that gray zone and probably giving a few more patients treatment than I have been in the past.”
Reference: Terrault N. Hepatitis B Panel Discussion. Presented at: National Liver Conference; October 25, 2019; San Antonio.
Disclosure: Brown reports he is a consultant for AbbVie, Dova, Gilead, Intercept and Shionogi; and has received research support from AbbVie, Gilead and Intercept.