Thursday, February 22, 2018

HBV Infection: When to Treat vs When to Monitor?

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HBV Infection: When to Treat vs When to Monitor?
Tram T. Tran, MD - 2/21/2018

Would you treat or monitor a patient with low HBV DNA levels and high ALT? Here’s my take.

One of the most complex issues in managing patients infected with HBV is determining when to treat vs when to monitor the infection. For example, what would you recommend for an HBeAg-positive middle-aged woman with HBV DNA < 20,000 IU/mL, ALT ≥ 2 x ULN, but no cirrhosis?

Like many patients with HBV infection, she may be asymptomatic, be reluctant to take long-term medications that do not immediately affect how she feels, have concerns about adverse events, or be at risk for nonadherence.

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