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NIH
Consensus Development Conference:
Management of Hepatitis B
October
20-22, 2008
Online Registration
Can’t Attend?
New!
CME
Information
Background
Information
Sponsors
Cosponsors and Partners
Preliminary Agenda
Logistics
Program and Abstract Book ( to be
released on the first day of the conference)
|
Hepatitis B is a major cause of
liver disease worldwide, ranking as a substantial cause of
cirrhosis and liver cancer. In the United States,
about 1.25 million people are chronically infected with the
virus, resulting in 3,000 to 5,000 deaths each year. However,
this condition occurs more frequently in high risk groups,
including Asian Americans, emigrants from areas of the world
where hepatitis B is common (China,
Korea, Southeast Asia, the Indian
Subcontinent, Africa, and Micronesia), men
who have sex with men, injection drug users, and recipients of
blood and blood products before screening procedures with
enhanced sensitivity were implemented in 1986. Since routine
hepatitis B vaccination of U.S. children
began in 1991, new cases of acute hepatitis B among children and
adolescents have dropped by more than 95%—and by 75% across all
age groups. In non-protected individuals, transmission can
result from exposure to infectious blood or body fluids
containing blood. A major impediment to diagnosis is that many
infected individuals are either asymptomatic or experience only
non-specific symptoms of disease, such as fatigue or muscle
ache.
For approximately 90% of adults, acute infection with the hepatitis B
virus is resolved by the body’s immune system and does not cause
long-term problems. The transition from acute to chronic infection
appears to occur when the immune system does not effectively destroy and
clear virus-infected cells. This leads to high blood levels of both
hepatitis B DNA and antigens, as well as antibodies produced by the body
in an attempt to combat the infection. The natural history of the
disease is not well understood, however, which makes management of this
complex disease challenging.
Questions remain as to which groups of patients benefit from therapy and
at which point in the course of their disease. Specific
recommendations for hepatitis B therapy are limited by a lack of
reliable long-term safety and efficacy information.
This is a difficult decision for physicians and patients, as treatments
are expensive and may have bothersome, if not harmful, effects on
patients; left untreated, however, chronic hepatitis B can lead to liver
failure and other serious liver problems. To examine these important
issues, the National Institute of Diabetes and Digestive and Kidney
Diseases and Office of Medical Applications of Research of the National
Institutes of Health will convene a
Consensus
Development Conference from October 20 to 22, 2008.
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What is the current
burden of hepatitis B?
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What is the natural
history of hepatitis B?
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What are the benefits
and risks of the current therapeutic options for hepatitis B?
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Which persons with
hepatitis B should be treated?
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What measures are
appropriate to monitor therapy and assess outcomes?
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What are the greatest
needs and opportunities for future research on hepatitis B?
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Presented by
Cosponsors
National
Cancer Institute
National Institute of Allergy and Infectious Diseases
Partners
Centers for Disease Control and Prevention
(CDC)
Food and Drug Administration (FDA)
Preliminary
Agenda
(pdf
version)
| Monday,
October 20, 2008 |
|
|
| 8:30 a.m. |
Opening Remarks |
|
Griffin P. Rodgers, M.D.
(pending confirmation) |
|
Director |
|
|
National Institute of Diabetes and
Digestive and Kidney Diseases |
|
National Institutes of Health |
|
|
| 8:40 a.m. |
Charge to the Panel |
|
Susan Rossi, Ph.D.,
M.P.H. |
|
Deputy Director |
|
Office of Medical Applications of
Research |
|
Office of the Director |
|
National Institutes of Health |
|
|
| 8:50 a.m. |
Conference Overview and Panel
Activities |
|
Michael F. Sorrell, M.D. |
|
Panel and Conference Chairperson |
|
Robert L. Grissom Professor of
Medicine |
|
Section of Gastroenterology and
Hepatology |
|
University of Nebraska Medical
Center |
|
|
| 1.
What Is the Current Burden of Hepatitis B? |
|
|
| 9:00 a.m. |
Hepatitis B Virus and the Disease It
Causes |
|
T. Jake Liang, M.D. |
|
Chief, Liver Diseases Branch |
| |
National Institute of Diabetes and
Digestive and Kidney Diseases |
|
National Institutes of Health |
|
|
| 9:20 a.m. |
Evaluation of the Patient With
Hepatitis B |
|
Eugene Schiff, M.D.,
M.A.C.P., F.R.C.P., M.A.C.G. |
|
Chief, Division of Hepatology |
|
Director, Center for Liver Diseases |
|
University of Miami School of
Medicine |
|
Miami, FL |
|
| |
|
| 9:40 a.m. |
Epidemiology of Hepatitis B |
|
W. Ray Kim, M.D. |
|
Associate Professor of Medicine |
|
Division of Gastroenterology and
Hepatology |
|
Mayo Clinic |
|
Rochester, MN |
|
|
| 10:00 a.m. |
Recommendations for Identification
and Public Health Management of Persons With Chronic Hepatitis B Virus
Infection |
|
Cindy Weinbaum, M.D.,
M.P.H. |
|
Team Leader |
|
Prevention Branch, Division of Viral Hepatitis |
|
Centers for Disease Control and
Prevention |
|
Atlanta,
GA |
|
|
| 10:20 a.m. |
Discussion |
|
|
|
|
| 2. What Is the Natural History of Hepatitis
B? |
|
|
| 11:00 a.m. |
Introduction to the Natural History
of Hepatitis B |
|
Brian J. McMahon, M.D. |
|
Scientific Program and Clinical
Director |
|
Liver Disease and Hepatitis Program |
|
Alaska
Native Medical Center |
|
Anchorage, AK |
|
|
| 11:20 a.m. |
Hepatitis B and Liver Cancer |
|
Adrian M. Di
Bisceglie,
M.D., F.A.C.P. |
|
Chief
of Hepatology, Division of Gastroenterology and Hepatology |
|
Saint Louis University
School of Medicine |
|
Saint Louis, MO |
|
|
| 11:40 a.m. |
Liver Biopsy Findings
in Chronic Hepatitis B |
|
David E.
Kleiner, M.D., Ph.D. |
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Chief, Postmortem Pathology and
Director of Clinical Operations |
|
Center for Cancer Research |
|
Laboratory of Pathology |
|
National Cancer Institute |
|
National Institutes of Health |
|
|
| 12:00 p.m. |
Lunch |
|
|
Panel Executive Session |
|
|
| 1:00 p.m. |
HBV DNA Levels and Outcomes of
Chronic Hepatitis B |
|
Chien-Jen Chen, Sc.D., M.P.H. |
|
Minister, Taiwan National Science
Council |
|
Executive Yuan |
|
Republic of China |
|
Taipei, Taiwan |
|
|
| 1:20 p.m. |
Evidence-Based Practice Center
Presentation I |
|
EPC Speaker |
|
|
| 1:40 p.m. |
Discussion |
|
|
| 3. What Are the Benefits and Risks of the
Current Therapeutic Options for Hepatitis B? |
|
|
| 2:30 p.m. |
Overview of the Risks and Benefits
of Current Theraputic Options for Hepatitis B |
|
E. Jenny
Heathcote, M.D., F.R.C.P.C. |
|
Head,
Division of Patient Based Clinical Research |
|
Toronto
Western Research Institute |
|
Toronto, Ontario |
|
Canada |
|
|
|
| 2:50 p.m. |
Benefits and Risks of Interferon
Therapy for Hepatitis B |
|
Robert P.
Perrillo, M.D. |
|
Associate Director,
Hepatology Division |
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Program Director, Transplant
Hepatology |
|
Baylor Universisty Medical Center |
|
Dallas, TX |
|
|
|
| 3:10 p.m. |
Benefits
and Risks of Nucleoside Analogues for Hepatitis B |
|
Jules L.
Dienstag, M.D. |
|
Dean for Medical Education |
|
Carl W. Walter Professor of
Medicine |
|
Harvard Medical School |
|
Boston, MA |
|
|
| 3:30 p.m. |
Benefits and Risks of Combination
Therapy for Hepatitis B |
|
Norah A.
Terrault, M.D.,
M.P.H. |
|
Assistant Professor, Medicine and
Gastroenterology |
|
UCSF School of Medicine |
|
San Francisco, CA |
|
|
| 3:50 p.m. |
Evidence-Based
Practice Center Presentation II |
|
EPC
Speaker |
| |
|
| 4:10
p.m. |
Discussion |
|
|
| 5:00
p.m. |
Adjournment |
|
|
|
Tuesday,
October 21, 2008
|
| 4. Which Persons With Hepatitis B Should Be
Treated? |
|
|
| 8:30
a.m. |
Indications for Therapy in Hepatitis
B |
|
Anna S. K.
Lok, M.D., M.R.C.P. |
|
Director of Clinical Hepatology |
|
University of Michigan Medical
School |
|
Ann Arbor, MI |
|
|
| 8:50
a.m. |
HIV/HBV Coinfection |
|
Chloe L.
Thio, M.D. |
|
Associate Professor of Medicine |
|
Division of Infectious Diseases |
|
Johns Hopkins School of Medicine |
|
Baltimore, MD |
|
|
| 9:10
a.m. |
Special Populations and Hepatitis B |
|
Marion G. Peters, M.D. |
|
John V. Carbone, M.D. Endowed Chair
in Medicine |
|
Director of Hepatology Research |
|
UCSF School of Medicine |
|
San
Fransisco, CA |
|
|
| 9:30
a.m. |
Prevention of Reactivation of
Hepatitis B |
|
Jay H.
Hoofnagle, M.D. |
|
Director, Liver Disease Research
Branch |
|
Division of Digestive Diseases and
Nutrition |
|
National Institute of Diabetes and
Digestive and Kidney Diseases |
|
National Institutes of Health |
|
|
| 9:50 a.m. |
Evidence-Based
Practice Center Presentation II |
|
EPC Speaker |
|
|
| 10:10 a.m. |
Discussion |
| |
|
| 5. What Measures Are Appropriate To Monitor
Therapy of Hepatitis B and Assess Outcomes? |
|
|
| 11:00 a.m. |
Monitoring During and After
Antiviral Therapy for Hepatitis B |
|
Ray Chung, M.D. |
|
Assistant Professor of Medicine |
|
Harvard Medical School |
|
Medical Director, Liver Transplant
Program |
|
Massachusetts General Hospital |
|
Boston, MA |
|
|
| 11:20 a.m. |
Antiviral Resistance and Hepatitis B
Therapy |
|
Mark G.
Ghany, M.D. |
|
Investigator, Liver Diseases Branch |
|
National Institute of Diabetes and
Digestive and Kidney Diseases |
|
National Institutes of Health |
|
|
| 11:40 a.m. |
Side Effects of Long-Term Antiviral
Therapy for Hepatitis B |
|
Robert J. Fontana, M.D. |
|
Associate Professor, Department of
Internal Medicine |
|
Medical Director of Liver
Transplantation |
|
University of Michigan Medical
School |
|
Ann Arbor, MI |
|
|
|
|
| 12:00 a.m. |
Discussion |
|
|
| 12:30 p.m. |
Adjournment |
|
|
| Wednesday,
October 22, 2008 |
|
|
| 9:00
a.m. |
Presentation of the Draft
Consensus Statement |
|
|
| 9:30
a.m. |
Public Discussion |
|
|
| 11:00
a.m. |
Panel Meets in Executive
Session |
|
|
| 2:00
p.m. |
Press Conference |
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