Table 1. Definitions of HBV Reactivation and Outcomes
Virologic outcomes Definitions
HBV reactivation Chronic HBV • ≥2 log (100-fold) increase in HBV
DNA compared to baseline or
• HBV DNA ≥3 log (1,000) IU/mL if
previously undetectable HBV DNA or
• HBV DNA ≥4 log (10,000) IU/mL if
baseline HBV DNA not available
Past HBV • HBV DNA detectable
• Reverse HBsAg seroconversion
(HBsAg-negative to HBsAg-positive)
Hepatitis flare ALT increase >3× baseline and >100
U/L
Clinical outcomes Definitions
HBV-associated hepatitis flare HBV reactivation plus hepatitis flare
HBV-associated liver failure • Impaired synthetic function (total
bilirubin >3 mg/dL or INR >1.5) or
• Ascites or
• Encephalopathy
Death attributed to HBV reactivation Following HBV-associated liver failure
Table 2. Interpretation of HBV Test Results
HBV status
Hepatitis B
surface antigen
(HBsAg)
Hepatitis
B core
antibody
(anti-HBc)
Antibody to
hepatitis B
surface antigen
(anti-HBs)
Chronic HBV infection + + –
Past HBV
infection
Resolved – + +
Isolated core – + –
anti-HBc is total Ig or IgG test.
