Bibliographic information
Recommendation
Treatment is recommended for all adolescents (aged ≥12 years) with chronic hepatitis B (CHB) (including pregnant women and girls and women of reproductive age) with HBV DNA >2000 IU/mL and an ALT level above the upper limit of normal (ULN) (30 U/L for boys and 19 U/L for girls). For adolescents, this should be based on ALT>ULN on at least two occasions in a 6- to 12-month period.
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
Chronic hepatitis B (CHB): Defined as the presence of HBsAg on at least one occasion, and for adolescents and children, persistence of HBsAg for six months or more. The ULN for ALT have been defined as <30 U/L for men and boys and <19 U/L for women and girls for consistency. Some guidelines use different ULN ALT levels for adolescents and children (<22 U/L for girls and <25 U/L for boys). Raised ALT may normalize in pregnancy and is therefore not a good marker for deciding about long-term treatment in pregnancy. Pregnant women should be reassessed after delivery.