title: Practical approach in hepatitis B e antigen-negative individuals to identify treatment candidates.
abstract: The natural history of chronic hepatitis B is characterized by different phases of infection, and patients may evolve from one phase to another or may revert to a previous phase. The hepatitis B e antigen (HBeAg)-negative form is the predominant infection worldwide, which consists of individuals with a range of viral replication and liver disease severity. Although alanine transaminase (ALT) remains the most accessible test available to clinicians for monitoring the liver disease status, further evaluations are required for some patients to assess if treatment is warranted. Guidance from practice guidelines together with thorough investigations and classifications of patients ensure recognition of who needs which level of care. This article aims to assist physicians in the assessment of HBeAg-negative individuals using liver biopsy or non-invasive tools such as hepatitis B s antigen quantification and transient elastography in addition to ALT and hepatitis B virus DNA, to identify who will remain stable, who will reactivate or at risk of disease progression hence will benefit from timely initiation of anti-viral therapy.
authors.affiliation: Ahmad Najib Azmi, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, 55100 Kuala Lumpur, Malaysia.
authors.forename: Ahmad Najib
authors.initials: AN
authors.lastname: Azmi
authors.affiliation: Ahmad Najib Azmi, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, 55100 Kuala Lumpur, Malaysia.
authors.forename: Soek-Siam
authors.initials: SS
authors.lastname: Tan
authors.affiliation: Ahmad Najib Azmi, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, 55100 Kuala Lumpur, Malaysia.
authors.forename: Rosmawati
authors.initials: R
authors.lastname: Mohamed
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000821:virology; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000187:drug effects* / Q000276:immunology / Q000472:pathogenicity; D006801:Humans; D018579:Patient Selection; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D006513:Hepatitis B e Antigens
keywords: Chronic hepatitis B; Hepatitis B e antigen-negative; Hepatitis B s antigen level; Nucleos(t)ides analogues; Pegylated interferon; Treatment candidates