title: [Characterization of patients with chronic hepatitis B virus infection without indication for treatment].
abstract: Chronic infection by the hepatitis B virus (HBV) is a dynamic process that results from the interaction between HBV replication and the host's immune response. In accordance with the consensus document of the European Association for the Study of the Liver, treatment is not indicated for the immune tolerant and inactive carrier phases. However, there are situations in the 2 phases (which we could call gray areas of chronic HBV infection) in which the correct categorization of patients is not easy and in which the start of treatment can be proposed. In the immune tolerant phase, treatment could be indicated for health professionals whose responsibilities require their participation in invasive procedures. Treatment could also be indicated for pregnant women who are HBeAg-positive, ALT normal and have high HBV DNA values and for whom oral antiviral treatment is indicated during the last trimester of pregnancy to reduce the risk of vertical HBV transmission from mother to child. For patients in the inactive carrier phase who are HBeAg-negative with persistent normal ALT levels and HBV DNA ≥ 2000 IU/mL, the intensity of the hepatic lesion will determine the indication for treatment. If these patients already have established cirrhosis then treatment is indicated if the HBV DNA is detectable, regardless of the ALT level.
authors.affiliation: Unidad de Hepatología, CIBERehd, Servicio de Aparato Digestivo, Hospital Germans Trias i Pujol, Badalona, Barcelona, España. Electronic address: rplanas.germanstrias@gencat.cat.
authors.forename: Ramon
authors.initials: R
authors.lastname: Planas
mesh_terms: D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy / Q000276:immunology; D006801:Humans
chemical_list: D006513:Hepatitis B e Antigens
keywords: Chronic hepatitis B; HBsAg values; Hepatitis crónica B; Immune tolerant; Inactive HBV carrier; Portador inactivo del VHB; Tolerancia inmune; Valores del HBsAg