| a) |
Chronic HBV-infection defined as HBsAg or HBV-DNA positive > 6 months |
| b) |
Serum HBV-DNA levels have been demonstrated to be associated with a linear increased risk for development of liver cirrhosis and HCC; please note that the conversion from copies to IU/ml varies depending on which test assay was used; in general 1 IU/ml equals around 5 copies or genome equivalents; one picogram HBV-DNA equals 2,8x105 genome/ml |
| c) |
Patients with replicating HBV and normal liver enzymes may have significant liver damage, therefore consider assessment of liver damage; this may be done using either liver biopsy or non invasive tools, including serum fibrosis markers or FibroScan. Non invasive methods for the evaluation of liver fibrosis are not fully validated in patients with Hepatitis B (especially in those with normal liver enzymes) and proposed cut offs are not the same as identified in patients with hepatitis C. While liver biopsy may provide additional information on inflammation and other lesions (e.g. steatosis), non-invasive markers can be used at more frequent intervals. |
| d) |
Please note normal ALT is < 19 IU/l for women, and < 31 IU/l for men |
