Figure 7:

Suggested algorithm for management of patients with hepatitis B viral cirrhosis. Cirrhotic patients are at high risk of hepatic decompensation with virological and biochemical (hepatic) flares and progression to HCC. Thus, potent nucleos(t)ide analogue therapy is recommended with TDF or ETV (if there is no history of lamivudine resistance). Some studies indicate that initiating combination therapy is beneficial to rapidly suppress viral load in patients with cirrhosis.

ETV = entecavir; HBV = hepatitis B virus; HCC = hepatocellular carcinoma; TAF = tenofovir alafenamide; TDF = tenofovir disoproxil fumarate.