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Copyright ©The Author(s) 2021.
World J Gastroenterol. Sep 28, 2021; 27(36): 6053-6063
Published online Sep 28, 2021. doi: 10.3748/wjg.v27.i36.6053
Table 3 Differences among recommendations and indications for treatment of chronic hepatitis B virus infection in adults, adolescents, and children from five professional societies or international organizations
Organization
ESPGHAN[16]HBeAg-positive adolescents and children with persistent alanine aminotransferase elevation for at least 6 mo
HBeAg-negative adolescents and children with persistent alanine aminotransferase elevation for at least 6 mo for at least 12 mo
HBV DNA > 2000 IU/mL and either
Moderate necroinflammation or fibrosis
Mild inflammation or fibrosis with a family history of hepatocellular carcinoma
AASLD[17]HBeAg-positive adolescents and children with both elevated alanine aminotransferase and measurable HBV DNA concentrations
Therapy should be deferred when HBV DNA is < 10000 IU/mL, until spontaneous HBeAg seroconversion is excluded
APASL[18]Non-cirrhotic HBeAg-positive adolescents and children when HBV DNA level is higher than 20000 IU/mL and alanine aminotransferase is more than twice the upper limit of normal for more than 12 mo
Non-cirrhotic HBeAg-positive adolescents and children either HBV DNA > 20000 IU/mL and ALT more than two times ULN for more than 12 mo, or a family history of hepatocellular carcinoma or cirrhosis and moderate-to-severe inflammation or pronounced fibrosis
Non-cirrhotic, HBeAg-positive chronic HBV infection, HBV DNA < 20000 IU/mL and moderate to severe inflammation or pronounced fibrosis
Non-cirrhotic, HBeAg-negative chronic HBV infection, HBV DNA > 2000 IU/mL, and ALT more than two times ULNNon-cirrhotic, HBeAg-negative chronic HBV infection and moderate to severe inflammation or pronounced fibrosis, regardless of HBV DNA concentration
EASL[11]A conservative approach is warranted
ESPGHAN: European Society for Paediatric Gastroenterology Hepatology and Nutrition; HBeAg: Hepatitis B e antigen; HBV: Hepatitis B virus; DNA: Deoxyribonucleic acid; AASLD: American Association for the Study of Liver Diseases; APASL: Asian Pacific Association for the Study of the Liver; ALT: Alanine aminotransferase levels; ULN: Upper limit of normal; EASL: European Association for the Study of the Liver.