🟡 Chronic Hepatitis B Antiviral Treatment Indications
UseUse to triage to treatment, deferral with follow-up, or no treatment, applying the expanded risk-factor indic…
SourceChinese Society of Infectious Diseases. Guidelines for the prevention and treatment of chronic hepa…
This-shift next steps
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Methodology · worked example, guidelines & full notes
An HBV DNA–positive person with normal ALT still warrants treatment once any single risk factor (age > 30, family history, fibrosis, extrahepatic disease) is present. (original synthesis · not guideline verbatim)
When to use
Use to triage to treatment, deferral with follow-up, or no treatment, applying the expanded risk-factor indications of the 2022 Chinese HBV guideline.
How it works
Cirrhosis → treat regardless of ALT/DNA. HBV DNA+ with ALT > ULN → treat. HBV DNA+ with normal ALT but family history/age > 30/G≥2 or F≥2/extrahepatic → treat. Otherwise follow up. Drugs: ETV/TDF/TAF.
Key points
- An HBV DNA–positive person with normal ALT still warrants treatment once any single risk factor (age > 30, family history, fibrosis, extrahepatic disease) is present. (original synthesis · not guideline verbatim)
- Cirrhosis is treated regardless of ALT, HBV DNA, or HBeAg, including decompensated DNA-negative disease.
- Immunosuppression/chemotherapy requires prophylactic antivirals to prevent reactivation even without active disease.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| HBV cirrhosis (compensated or decompensated) | Present |
|---|---|
| Serum HBV DNA | Positive (detectable) |
| ALT persistently > upper limit of normal (other causes excluded) | Yes |
| Age > 30 yr | Yes |
| Family history of HBV cirrhosis or hepatocellular carcinoma (HCC) | Present |
| Significant hepatic inflammation (G ≥ 2) or fibrosis (F ≥ 2) | Present |
| HBV-related extrahepatic manifestations (e.g. glomerulonephritis) | Present |
→Antiviral indicationAntiviral treatment recommended
- Basis for decision：HBV cirrhosis (compensated/decompensated) is treated regardless of ALT, HBV DNA, or HBeAg
- Recommended drugs：ETV (entecavir) / TDF (tenofovir disoproxil) / TAF (tenofovir alafenamide)
- Basis：Chinese Guideline for the Prevention and Treatment of Chronic Hepatitis B 2022
| HBV cirrhosis (compensated or decompensated) | Absent |
|---|---|
| Serum HBV DNA | Negative |
| ALT persistently > upper limit of normal (other causes excluded) | No/normal |
| Age > 30 yr | No |
| Family history of HBV cirrhosis or hepatocellular carcinoma (HCC) | Absent |
| Significant hepatic inflammation (G ≥ 2) or fibrosis (F ≥ 2) | Absent |
| HBV-related extrahepatic manifestations (e.g. glomerulonephritis) | Absent |
→Antiviral indicationGenerally not needed, follow-up monitoring
- Basis for decision：HBV DNA negative, no cirrhosis
- Recommendation：Periodic follow-up; prophylactic antiviral therapy is needed before chemotherapy/immunosuppression/B-cell monoclonal antibodies or hematopoietic stem-cell transplant
- Basis：Chinese Guideline for the Prevention and Treatment of Chronic Hepatitis B 2022
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Chronic Hepatitis B Antiviral Treatment Indications?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Chronic Hepatitis B Antiviral Treatment Indications upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Chronic Hepatitis B Antiviral Treatment Indications calculated in practice? Can you show a worked example?
- Inputs: HBV cirrhosis (compensated or decompensated) Present, Serum HBV DNA Positive (detectable), ALT persistently > upper limit of normal (other causes excluded) Yes, Age > 30 yr Yes, Family history of HBV cirrhosis or hepatocellular carcinoma (HCC) Present, Significant hepatic inflammation (G ≥ 2) or fibrosis (F ≥ 2) Present, HBV-related extrahepatic manifestations (e.g. glomerulonephritis) Present → Result: Antiviral indication Antiviral treatment recommended（Basis for decision: HBV cirrhosis (compensated/decompensated) is treated regardless of ALT, HBV DNA, or HBeAg, Recommended drugs: ETV (entecavir) / TDF (tenofovir disoproxil) / TAF (tenofovir alafenamide), Basis: Chinese Guideline for the Prevention and Treatment of Chronic Hepatitis B 2022） Inputs: HBV cirrhosis (compensated or decompensated) Absent, Serum HBV DNA Negative, ALT persistently > upper limit of normal (other causes excluded) No/normal, Age > 30 yr No, Family history of HBV cirrhosis or hepatocellular carcinoma (HCC) Absent, Significant hepatic inflammation (G ≥ 2) or fibrosis (F ≥ 2) Absent, HBV-related extrahepatic manifestations (e.g. glomerulonephritis) Absent → Result: Antiviral indication Generally not needed, follow-up monitoring（Basis for decision: HBV DNA negative, no cirrhosis, Recommendation: Periodic follow-up; prophylactic antiviral therapy is needed before chemotherapy/immunosuppression/B-cell monoclonal antibodies or hematopoietic stem-cell transplant, Basis: Chinese Guideline for the Prevention and Treatment of Chronic Hepatitis B 2022）