Chronic hepatitis B: Is it time for expanded antiviral treatment?

Table 3 Management of phase 2 or phase 4 of chronic hepatitis B virus infection

	APASL[11]	EASL[10]	AASLD[8,9]	INASL[12]	KASL[13]
Biopsy	ALT 1-2 × ULN and significant fibrosis on non-invasive assessment	ALT 1-2 × ULN and significant fibrosis on non-invasive assessment	ALT 1-2 × ULN	HBeAg (+) with ALT between 40 and 80 IU/L and HBV DNA > 20000 IU/mL	ALT 1-2 × ULN HBeAg (-) and DNA > 2000 IU/mL
Treat	HBeAg (+) ALT > 2 × ULN HBV DNA > 20000 IU/mL	HBeAg (+) ALT > 2 × ULN, HBV DNA > 20000 IU/mL	HBeAg (+), ALT > 2 × ULN, HBV DNA > 20000 IU/mL	HBeAg (+), ALT > 80 IU/L, HBV DNA > 20000 IU/mL	HBeAg (+), ALT > 2 × ULN, HBV DNA > 20000 IU/mL
	HBeAg (-), ALT > 2 × ULN, HBV DNA > 2000 IU/mL	HBeAg (-), ALT > 40 IU/L, HBV DNA > 2000 IU/mL	HBeAg (-), ALT > 2 × ULN, HBV DNA > 2000 IU/mL	HBeAg (-), ALT > 80, HBV DNA > 2000 or > 20000 IU/mL (with normal ALT)	HBeAg (-), ALT > 2 × ULN, HBV DNA > 2000 IU/mL
		Biopsy shows inflammation (> A2) or fibrosis (≥ F2)	Biopsy shows inflammation (> A2) or fibrosis (≥ F2)	Biopsy shows inflammation (> A2) or fibrosis (≥ F2)	Biopsy shows inflammation (> A2) or fibrosis (≥ F2)
May treat			If ALT 1-2 × ULN, consider the severity of liver disease

APASL: Asian Pacific Association for the Study of the Liver; EASL: European Association for the Study of the Liver; AASLD: American Association for the Study of Liver Diseases; INASL: Indian National Association for Study of the Liver; KASL: Korean Association for the Study of the Liver; HBV: Hepatitis B virus; ULN: Upper limit of normal; ALT: Alanine aminotransferase; HBeAg: Hepatitis B e antigen; HCC: Hepatocellular cancer.