Table 2. Summary of Anti–Hepatitis B Virus Treatment Indications as Recommended by Major Practice Guidelines

	Practice Guidelines
	AASLD¹⁰	APASL¹¹	EASL¹²
HBeAg-positive	∙ HBV DNA >20,000 IU/mL ∙ ALT >2× ULN ∙ No spontaneous HBeAg seroconversion after 3–6 months' observation	∙ HBV DNA ≥20,000 IU/mL ∙ ALT ≥2× ULN	∙ HBV DNA >20,000 IU/mL ∙ ALT >2× ULN
	∙ HBV DNA >20,000 IU/mL ∙ ALT ≤2× ULN ∙ Moderate or worse liver inflammation or significant fibrosis (on biopsy^*)	∙ HBV DNA ≥20,000 IU/mL ∙ ALT ≥1 to <2× ULN ∙ Moderate or worse liver inflammation or fibrosis (on biopsy or noninvasive fibrosis assessment^*)	∙ HBV DNA >2000 IU/mL ∙ ALT >1× ULN ∙ Moderate or worse liver inflammation or moderate fibrosis (using a standardized scoring system^{^†})
	∙ HBV DNA >2000 IU/mL ∙ Cirrhosis	∙ HBV DNA ≥2000 IU/mL ∙ Advanced fibrosis/cirrhosis	∙ Detectable HBV DNA ∙ Cirrhosis
HBeAg-negative	∙ HBV DNA >20,000 IU/mL ∙ ALT >2× ULN	∙ HBV DNA ≥2000 IU/mL ∙ ALT >2× ULN	∙ HBV DNA >20,000 IU/mL ∙ ALT >2× ULN
	∙ HBV DNA >2000 IU/mL ∙ ALT ≥1–2× ULN ∙ Moderate or worse liver inflammation or significant fibrosis (on biopsy)	∙ HBV DNA ≥2000 IU/mL ∙ ALT ≥1 to <2× ULN ∙ Moderate or worse liver inflammation or fibrosis (on biopsy or noninvasive fibrosis assessment^*)	∙ HBV DNA >2000 IU/mL ∙ ALT >1× ULN ∙ Moderate or worse liver inflammation or moderate fibrosis
	∙ HBV DNA >2000 IU/mL ∙ Cirrhosis	∙ HBV DNA ≥2000 IU/mL ∙ Advanced fibrosis/cirrhosis	∙ Detectable HBV DNA ∙ Cirrhosis

↵* Assessment of liver disease is recommended if the patient is 40 years or older.
↵† Assessment of liver disease is recommended if the patient is 30 years or older. Biopsy is to be considered in patients of older age and/or with fluctuating/minimally elevated alanine aminotransferase (ALT) concentrations or family history of hepatocellular carcinoma.
AASLD, American Association for the Study of Liver Diseases; APASL, Asian Pacific Association for the Study of the Liver; EASL, European Association for the Study of the Liver; HBeAg, hepatitis B e antigen; HBV, hepatitis B virus; ULN, upper limit of normal.