Criteria Useful in Determining for Whom Therapy is Indicated

U.S. Department of Health and Human Services
National Institutes of Health

Patients for whom therapy is indicated

Patients who have acute liver failure, cirr
hosis and clinical complications, cirrhosis or advanced fibrosis and HBV DNA in serum, or reactivation of chronic HBv after chemotherapy or immunosuppression and infants born to women who are HBsAg-positive [immunoglobulin and vaccination].

Patients for whom therapy may be beneficial

Patients in the immune-active phase who do not have advanced fibrosos and cirrhosis

Patients for whom immediate therapy is not routinely indicated

Patients with chronic hepatitis B in the immune-tolerant phase with high levels of serum HBV DNA but normal ALT levels of little activity on liver biopsy. Patients in the inactive carrier or low replicative phase with low levels or no detectable HBV DNA in serum and normal serum ALT levels. Patients who have latent HBV infection [HBV DNA without HBsAG]. The NIH also reccomends routine screening for hepatitis B of newly arrived immigrants to the United States from countries where the HBV prevalence rate is greater than 2%. Screening will facilitate the provesion of medical and public health services for infected patients and their families and provide health data on the burden of disease in immigrant populations. The screening test should not be used to prohibit immigration.

My personal take on hepatitis therapies is to be pro-active and attack this head on as aggresively as possible.
Scott