Aim of treatment

The aim of drug treatment for chronic hepatitis B is prolonged suppression of viral replication (indicated by undetectable hepatitis B virus [HBV] DNA using a sensitive assay). Suppression of viral replication reduces necroinflammation and fibrosis in the liver, and can prevent progression to liver failure and hepatocellular carcinoma.

The only durable treatment endpoint is loss of hepatitis B surface antigen (HBsAg), but this is infrequent (less than 1% of treated patients annually). In patients who are hepatitis B e antigen (HBeAg) positive, HBeAg seroconversion can be associated with sustained remission of disease and may be used as a treatment endpoint—stopping antiviral therapy with entecavir or tenofovir can be considered after a period of consolidation in patients without cirrhosis (see Duration of treatment and stopping therapy)Australian hepatitis B consensus statement 2022.