초록
Chronic hepatitis B (CHB) can progress to cirrhosis which is one of the important clinical consequences. Recently antiviral therapy is known to reduce hepatic inflammation and prevent progression to cirrhosis and/or decompensation/hepatocellular carcinoma (HCC). When to start and stop, how to minimize antiviral resistance are major issues to be solved in antiviral therapy. To prevent HBV viral resistance, potent antiviral therapy with high genetic barriers is recommended. However we are not free from national insurance coverage in clinical practice, and there are limitations in imbursement coverage in clinical practice. Recently, guidelines of imbursement has been amended with extended coverage that goes with KASL and other guidelines. Major changes include the extension of duration of drugs beyond 3 years and approval of antiviral therapy in cirrhotic/HCC patients even with mild elevation of AST/ALT. This article reviews recent advance in management of chronic hepatitis B focusing on changes of imbursement regulation.