Chronic hepatitis B

Persistent (over 6 months) hepatitis B virus infection with HBsAg persistence. Without treatment leads to cirrhosis and hepatocellular carcinoma. Patients with active HBV-DNA replication and liver damage require antiviral therapy with oral nucleos(t)ide analogues.

ICD-10 B18.11 drug

Also known as: Chronic HBV infection, CHB

Drugs used for this condition

AEntecavirFirst line · Guanosine nucleoside analogue, anti-HBV agentFirst-line therapy for chronic hepatitis B in adults with compensated or decompensated liver disease, naïve to nucleos(t)ide analogues. EASL 2017 and the Spanish AEEH 2020 consensus position entecavir (0.5 mg/day) and tenofovir as equivalent first-line options in patients without lamivudine resistance. In lamivudine-resistant disease – switch to tenofovir rather than escalate entecavir. Therapy targets undetectable HBV-DNA and ALT normalisation; HBsAg seroconversion is rare.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit