02/02/2026
The European Association for the Study of the Liver ( EASL - The Home of Hepatology ) has published updated guidelines on the management of hepatitis B virus (HBV) infection.
The new guidelines acknowledge that there has been a shift towards treatment indications being based on HBV DNA level rather than traditional disease phases or Hepatitis B e antigen (HBeAg) status. They now recommend All individuals who are hepatitis B surface antigen (HBsAg)-positive with chronic HBV infection and advanced fibrosis or cirrhosis are candidates for antiviral therapy, provided they have detectable HBV DNA, regardless of serum alanine aminotransferase (ALT) level or level of viraemia. Some individuals who do not have advanced fibrosis or cirrhosis will still be candidates for antiviral therapy if their HBV DNA level is ≥2000 IU/mL and they fulfil other criteria such as co-existing risk factors.
Long-term suppression of HBV DNA level is associated with a reduced risk of liver inflammation and fibrosis, thereby preventing disease progression and the development of cirrhosis and HCC, leading to increased survival.
Other major international guidelines vary in their recommendations on antiviral therapy, but many are currently being updated.
For more on BMJ Best Practice, including specific indications for antivirals and variations in guidelines, go to https://bit.ly/46l69Pb.
