🟡 Chronic Hepatitis B Antiviral Treatment Indications
This tool judges whether a person with chronic HBV infection meets antiviral treatment indications using HBV DNA, ALT, cirrhosis, and risk factors.
Chronic Hepatitis B Antiviral Treatment Indications
HBV cirrhosis (compensated or decompensated)
Serum HBV DNA
ALT persistently > upper limit of normal (other causes excluded)
Age > 30 yr
Family history of HBV cirrhosis or hepatocellular carcinoma (HCC)
Significant hepatic inflammation (G ≥ 2) or fibrosis (F ≥ 2)
HBV-related extrahepatic manifestations (e.g. glomerulonephritis)
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
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.