{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:39:37Z","timestamp":1791909577948,"version":"4.3.4"},"reference-count":51,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,9,20]],"date-time":"2020-09-20T00:00:00Z","timestamp":1600560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Advancing Clinical Treatment - Liver Disease (ACT-LD) Taiwan."}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Globally, chronic hepatitis B (CHB) is a major public health concern. Timely and effective management can prevent disease progression to cirrhosis and reduce the risk of hepatocellular carcinoma (HCC). Currently, there is no consensus on the clinical management of CHB in East Asia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To establish an East Asia expert opinion on treatment initiation for CHB based on alanine aminotransferase (ALT) level, hepatitis B virus (HBV) deoxyribonucleic acid (DNA) level, cirrhosis and HCC risk scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A meeting was held online with a panel of 10 experts from East Asia to discuss ALT, HBV DNA, cirrhosis and HCC risk scores. Indications for CHB treatment in the latest international guidelines were reviewed. Consensus was summarised to provide recommendations on the initiation of treatment for CHB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Anti\u2010viral therapy is recommended for CHB patients with (a) HBV DNA\u00a0\u2265\u00a02000\u00a0IU\/mL and ALT\u00a0\u2265\u00a01\u00d7 upper limit of normal (ULN); (b) HBV DNA\u00a0\u2265\u00a02000\u00a0IU\/mL, ALT\u00a0&lt;\u00a01\u00d7 ULN and\u00a0\u2265\u00a0F2 fibrosis and\/or\u00a0\u2265\u00a0A2 necroinflammation occurs; (c) cirrhosis and detectable HBV DNA; or (d) HBV DNA\u00a0\u2265\u00a02000\u00a0IU\/mL, ALT\u00a0&lt;\u00a01\u00d7 ULN and a family history of cirrhosis or HCC, extrahepatic manifestations or age\u00a0&gt;\u00a040\u00a0years. Patients with cirrhosis and\/or HCC should be treated regardless of ALT levels if HBV DNA level is detectable. Initiating anti\u2010viral therapy or close monitoring at 3\u2010month intervals is recommended for CHB patients with at least two HCC risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These expert recommendations will contribute to a new standard of daily clinical practice in East Asia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16097","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T07:11:43Z","timestamp":1600931503000},"page":"1540-1550","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["East Asia expert opinion on treatment initiation for chronic hepatitis B"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2442-7952","authenticated-orcid":false,"given":"Jia\u2010Horng","family":"Kao","sequence":"first","affiliation":[{"name":"Taipei 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