Recommendations for HCC Screening
����Screen with ultrasound examination of the liver every 6-12 months
HBV carriers at high risk for HCC such as:
������ Asian men > 40 years and Asian women > 50 years of age
������ Persons with cirrhosis
������ Persons with a family history of HCC
������ Africans > 20 years of age
������ Any carrier > 40 years with persistent or intermittent ALT elevation and/or high
HBV DNA level (> 2,000 IU/mL). (II-2)
����For HBV carriers at high risk for HCC who are living in areas where
ultrasound is not readily available, periodic screening with AFP should
be considered. (II-2)
Table 7. Definition of Terms Relating to Antiviral Resistance
to Nucleoside Analogue Treatment
Term
Definition
Virologic breakthrough
Increase in serum HBV DNA by > 1 log10 (10-fold)
above nadir after achieving virologic response, during
continued treatment
Viral rebound
Increase in serum HBV DNA to > 20,000 IU/mL
or above pretreatment level after achieving virologic
response, during continued treatment
Biochemical breakthrough
Increase in ALT above upper limit of normal after
achieving normalization, during continued treatment
Genotypic resistance
Detection of mutations that have been shown in ���
in vitro studies to confer resistance to the NA that is
being administered
Phenotypic resistance
In vitro confirmation that the mutation detected
decreases susceptibility (as demonstrated by increase in
inhibitory concentrations) to the NA administered
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