Guidelines on hepatitis B by the European Association for the Study of the Liver
All patients with HBeAg-positive or -negative chronic hepatitis B, defined by HBV DNA >2,000 IU/ml, alanine aminotransferase (ALT) greater than the upper limit of normal (ULN), and/or at least moderate liver necroinflammation or fibrosis, should be treated.
Patients with compensated or decompensated cirrhosis need treatment with any detectable HBV DNA level and regardless of ALT levels.
Patients with HBV DNA >20,000 IU/ml and ALT greater than 2 times the ULN should start treatment regardless of the degree of fibrosis.
Patients with HBeAg-positive chronic HBV infection, defined by persistently normal ALT and high HBV DNA levels, may be treated if they are older than 30 yr regardless of the severity of liver histologic lesions.
Patients with HBeAg-positive or HBeAg-negative chronic HBV infection and family history of hepatocellular carcinoma (HCC) or cirrhosis and extrahepatic manifestations can be treated even if typical treatment indications are not fulfilled.
For further reading, see Hepatitis B
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Cite this: John Anello, Brian Feinberg, John Heinegg, et. al. New Clinical Practice Guidelines, September 2017 - Medscape - Sep 15, 2017.