Treatment
Table 8. Recommendations for Treatment of Chronic
Hepatitis B
HBeAg
+
HBV DNA
(PCR)
ALT
Treatment Strategy
> 20,000
IU/mL
���2��
ULN
Low efficacy with current treatment.
Observe; consider treatment when ALT becomes
elevated.
Consider biopsy in persons > 40 years, ALT
persistently high normal (2 �� ULN) or with family
history of HCC.
Consider treatment if HBV DNA > 20,000 IU/mL
and biopsy shows moderate/severe inflammation or
significant fibrosis.
+
> 20,000
IU/mL
>2��
ULN
Observe for 3-6 months and treat if no spontaneous
HBeAg loss.
Consider liver biopsy prior to treatment if
compensated.
Immediate treatment if icteric or clinical
decompensation.
IFN-��/pegIFN-�� , LAM, ADV, ETV, TDF or LdT
may be used as initial therapy.
ADV NOT preferred due to weak antiviral activity and
high rate of resistance after 1st year.
LAM and LdT NOT preferred due to high rate of
drug resistance.
End-point of treatment ��� Seroconversion from HBeAg
to anti-HBe.
Duration of therapy:
������ IFN-��: 16 weeks
������ PegIFN-��: 48 weeks
������ LAM/ADV/ETV/LdT/TDF: ��� 1 year,
continue for at least 6 months after HBeAg
seroconversion
IFN-�� non-responders / contraindications to ���
IFN-�� ��� TDF/ETV.
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