Recommendations for HCC Screening
ÎScreen 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)
ÎFor 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 Virologic breakthrough Viral rebound Biochemical breakthrough Genotypic resistance Phenotypic resistance Definition Increase in serum HBV DNA by > 1 log10
above nadir after achieving virologic response, during continued treatment
(10-fold)
Increase in serum HBV DNA to > 20,000 IU/mL or above pretreatment level after achieving virologic response, during continued treatment
Increase in ALT above upper limit of normal after achieving normalization, during continued treatment
Detection of mutations that have been shown in
in vitro studies to confer resistance to the NA that is being administered
In vitro confirmation that the mutation detected decreases susceptibility (as demonstrated by increase in inhibitory concentrations) to the NA administered
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