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In February 2018, the American Association for the Study of Liver Diseases (AASLD) published an update to the practice guideline on the prevention, diagnosis, and treatment of chronic hepatitis B (CHB). In contrast with the prior version, this guidance document was developed by consensus of an expert panel, without formal systematic review or use of the Grading of Recommendations Assessment, Development, and Evaluation system. The 2018 guidance is based on the following: (1) formal review and analysis of published literature on the topics; (2) World Health Organization guidance on prevention, care, and treatment of CHB; and (3) the authors' experience in acute hepatitis B and CHB. This guidance is intended for use by health care providers, and this guidance identifies preferred approaches to the diagnostic, therapeutic, and preventive aspects of care for patients with CHB. As with clinical practice guidelines, it provides general guidance to optimize the care of the majority of patients and should not replace clinical judgment for a unique patient. This guidance does not seek to dictate a one‐size‐fits‐all approach for the management of CHB. Clinical considerations may justify a course of action that differs from this guidance. The 2018 HBV guideline is intended to complement the previous editions. The update addresses five major areas of change. The new version includes: (1) updates on treatment since the 2016 HBV guidelines (notably the use of tenofovir alafenamide) and guidance on (2) screening, counseling, and prevention; (3) specialized virological and serological tests; (4) monitoring of untreated patients; and (5) treatment of hepatitis B in special populations, including persons with viral coinfections, acute hepatitis B, recipients of immunosuppressive therapy, and transplant recipients. Please listen to Dr. Norah A. Terrault discuss. Further Educational HBV Resources can be found through the Following Fundamentals of Liver Disease online program, Hepatitis B unit: https: //liverlearning. aasld. org/aasld/2017/fold₂017/193371/aasld. html? f=cᵢd=193371. Program Overview The Fundamentals of Liver Disease Hepatitis B educational unit consists of 7 online interactive, narrated modules 30 to 40 minutes in length. The overall goal of the Fundamentals of Liver Disease program is to improve patient care by increasing learner competence and confidence in both proper patient identification and assessment and increasing learner performance in therapeutic options and on‐treatment management strategies for patients. Patient outcomes will be improved as a result of the improvements in more providers understanding these key components in the management and care of patients with liver diseases. Key Topics Included in the Fundamentals of Liver Disease Hepatitis B Unit: HBV: Epidemiology and Screening. Patient with positive Hepatitis B serologies. Natural history of HBV and identification of treatment candidates. Management of the Chronic HBV patient with co‐morbid and other conditions. Antiviral treatment of the Patient with Chronic HBV. Prevention of HBV infection. Hepatitis B in the Pediatric PatientHepatitis B in the Pediatric Patient.
Terrault et al. (Sun,) studied this question.