Table 3.
Management of phase 2 or phase 4 of chronic hepatitis B virus infection
|
|
APASL[11]
|
EASL[10]
|
AASLD[8,9]
|
INASL[12]
|
KASL[13]
|
| Biopsy | ALT 1-2 × ULN and significant fibrosis on non-invasive assessment | ALT 1-2 × ULN and significant fibrosis on non-invasive assessment | ALT 1-2 × ULN | HBeAg (+) with ALT between 40 and 80 IU/L and HBV DNA > 20000 IU/mL | ALT 1-2 × ULN HBeAg (-) and DNA > 2000 IU/mL |
| Treat | HBeAg (+) ALT > 2 × ULN HBV DNA > 20000 IU/mL | HBeAg (+) ALT > 2 × ULN, HBV DNA > 20000 IU/mL | HBeAg (+), ALT > 2 × ULN, HBV DNA > 20000 IU/mL | HBeAg (+), ALT > 80 IU/L, HBV DNA > 20000 IU/mL | HBeAg (+), ALT > 2 × ULN, HBV DNA > 20000 IU/mL |
| HBeAg (-), ALT > 2 × ULN, HBV DNA > 2000 IU/mL | HBeAg (-), ALT > 40 IU/L, HBV DNA > 2000 IU/mL | HBeAg (-), ALT > 2 × ULN, HBV DNA > 2000 IU/mL | HBeAg (-), ALT > 80, HBV DNA > 2000 or > 20000 IU/mL (with normal ALT) | HBeAg (-), ALT > 2 × ULN, HBV DNA > 2000 IU/mL | |
| Biopsy shows inflammation (> A2) or fibrosis (≥ F2) | Biopsy shows inflammation (> A2) or fibrosis (≥ F2) | Biopsy shows inflammation (> A2) or fibrosis (≥ F2) | Biopsy shows inflammation (> A2) or fibrosis (≥ F2) | ||
| May treat | If ALT 1-2 × ULN, consider the severity of liver disease |
APASL: Asian Pacific Association for the Study of the Liver; EASL: European Association for the Study of the Liver; AASLD: American Association for the Study of Liver Diseases; INASL: Indian National Association for Study of the Liver; KASL: Korean Association for the Study of the Liver; HBV: Hepatitis B virus; ULN: Upper limit of normal; ALT: Alanine aminotransferase; HBeAg: Hepatitis B e antigen; HCC: Hepatocellular cancer.