Hepatitis B treatment recommendations

The American Association for the Study of Liver Disease has made recommendations for treating long-term (chronic) hepatitis B. These recommendations are based on the presence of hepatitis B antigens in your blood, the level of hepatitis B viral DNA (HBV DNA) in your blood, and the levels of your liver enzymes.

Chronic hepatitis B can be HBeAg-positive or -negative. This means a specific hepatitis B antigen (HBeAg) is present (positive) or is not present (negative) in your blood. High levels of HBV DNA and liver enzymes may be present in both of these types of chronic hepatitis. This signifies an active virus and increased risk of liver damage.

Treatment with antiviral medication is recommended if you are:¹

• HBeAg-positive and have high levels of HBV DNA, and your liver enzymes are more than twice the normal level.
• HBeAg-negative and have lower levels of HBV DNA, and your liver enzymes are more than twice the normal level.
• Either HBeAg-positive or negative, have high levels of HBV DNA, and have cirrhosis.

Treatment with antiviral medication is not recommended if you are:¹

• HBeAg-positive and have high levels of HBV DNA, and your liver enzymes are less than twice the normal level.
• HBeAg-negative and have low levels of HBV DNA, and your liver enzymes are less than twice the normal level.

If you are either HBeAg-positive or -negative, have low levels of HBV DNA, and have cirrhosis, you may be monitored or need a liver transplant.

Citations

1. Lok ASF, McMahon BJ (2007). Chronic hepatitis B. Hepatology, 45(2): 507–539.