The Canadian Association for the Study of the Liver (CASL) and the Association of Medical Microbiology and Infectious Disease Canada (AMMI) have released their much-anticipated 2025 guidelines for the management of chronic hepatitis B (HBV). These updated guidelines reflect the latest advancements in research and clinical practice, aiming to enhance patient care and outcomes.
Key Updates and Recommendations
1. Enhanced Screening and Diagnosis: The 2025 guidelines emphasize the importance of early detection through enhanced screening protocols. They recommend routine screening for high-risk populations, including immigrants from endemic regions, individuals with a history of intravenous drug use, and those with HIV.
2. Updated Treatment Algorithms: The new guidelines introduce updated treatment algorithms that incorporate the latest antiviral therapies. These algorithms are designed to provide personalized treatment plans based on the patient’s stage of disease, viral load, and liver function.
3. Focus on Long-term Monitoring: Long-term monitoring is crucial for managing chronic HBV effectively. The guidelines recommend regular follow-ups with liver function tests, viral load assessments, and imaging studies to detect any progression of liver disease or development of hepatocellular carcinoma (HCC).
4. Integration of New Antiviral Agents: The 2025 update includes recommendations for the use of new antiviral agents that have shown promise in clinical trials. These agents offer improved efficacy and safety profiles, providing more options for patients who may not respond to traditional therapies.
5. Addressing Special Populations: Special attention is given to managing chronic HBV in pregnant women, children, and individuals with co-infections such as HIV or hepatitis C. The guidelines provide tailored recommendations to ensure these populations receive appropriate care.
6. Public Health and Prevention: The guidelines underscore the importance of vaccination and public health initiatives to prevent the spread of hepatitis B. They advocate for increased awareness campaigns and vaccination programs, particularly in high-risk communities.
Conclusion
The 2025 guidelines from CASL and AMMI represent a significant step forward in the management of chronic hepatitis B. By incorporating the latest research and clinical practices, these guidelines aim to improve patient outcomes and reduce the burden of chronic HBV in Canada. Healthcare providers are encouraged to familiarize themselves with these updates and integrate them into their practice to ensure the best possible care for their patients.
Authors: Clinical Practice Guidelines Committee Chair, Carla Osiowy, PhD, Panel Members, Fernando Alvarez, MD, Carla S Coffin, MD, MSc Scott.Fung@uhn.ca, Curtis L Cooper, MD, Scott K Fung, MD, Hin Hin Ko, Sébastien Poulin, MD, MSc, and Jennifer van Gennip, BSc
Author information and affiliations
For more detailed information, healthcare professionals can access the full guidelines on the Canadian Liver Journal – Volume 8, Number 2 – https://doi.org/10.3138/canlivj-2025-0012-e
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