Viral hepatitis: A brief introduction, review of management, advances and challenges

Table 3 European Association for the Study of the Liver 2017 clinical practice guidelines on the management of hepatitis B virus infection[12]

Clinical practice guidelines
All patients with HBeAg-positive or -negative chronic hepatitis B, defined by HBV DNA (2000 IU/mL, ALT) upper limit of normal (ULN) and/or at least moderate liver necroinflammation or fibrosis, should be treated (Evidence level I, grade of recommendation 1)
Patients with compensated or decompensated cirrhosis need treatment, with any detectable HBV DNA level and regardless of ALT levels (Evidence level I, grade of recommendation 1)
Patients with HBV DNA (20000 IU/mL, and ALT) 2 × ULN should start treatment regardless of fibrosis degree (Evidence level II-2, grade of recommendation 1)
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 years regardless of the severity of liver histological lesions (Evidence level III, grade of recommendation 2)
Patients with HBeAg-positive or HBeAg-negative chronic HBV infection and family history of HCC or cirrhosis and extra-hepatic manifestations can be treated even if typical treatment indications are not fulfilled (Evidence level III, grade of recommendation 2)

HBV: Hepatitis B virus; HBeAg: Hepatitis B e-antigen; ALT: Alanine transaminase.