Treatment
Hepatitis B Carriers Who Require Immunosuppressive or
Cytotoxic Therapy
����Perform HBsAg and anti-HBc testing in patients who are at high risk
of HBV infection (see Table 2) prior to initiating chemotherapy or
immunosuppressive therapy. (II-3)
����Prescribe prophylactic antiviral therapy for HBV carriers at the onset
of cancer chemotherapy or a finite course of immunosuppressive
therapy.
������ Patients with baseline HBV DNA < 2,000 IU/mL should continue treatment for ���
6 months after completion of chemotherapy or immunosuppressive therapy. (III)
������ Patients with high baseline HBV DNA (> 2,000 IU/mL) should continue
treatment until they reach treatment endpoints as in immunocompetent ���
patients. (III)
������ Use lamivudine or telbivudine if the anticipated duration of treatment is short ���
(��� 12 months) and baseline serum HBV DNA is not detectable. (I for lamivudine;
III for telbivudine)
������ Tenofovir or entecavir is preferred if longer duration of treatment is anticipated. (III)
������ IFN-�� should be avoided in view of the bone marrow suppressive effect. (II-3)
Acute Symptomatic Hepatitis B
����Treatment is indicated only for patients with fulminant hepatitis B and
those with protracted, severe acute hepatitis B. (III)
����Use lamivudine or telbivudine when the anticipated duration of
treatment is short. Otherwise, entecavir is preferred. (II-3)
������ Continue treatment until HBsAg clearance is confirmed or indefinitely in those
who undergo liver transplantation. (II-1)
������ IFN-�� is contraindicated. (III)
Monitoring Chronic HBV Infection (Figure 2)
����HBeAg-positive and HBeAg-negative patients who meet criteria
for chronic hepatitis B (see Key Points) should be evaluated for
treatment. (I)
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