[Consensus document of the Spanish Association for the Study of the Liver on the treatment of hepatitis B infection (2012)]

2012 Gastroenterologia y hepatologia 35, 7 (512-528)

Diagnosis and classification of chronic HBV infection
Several clinical studies indicate that liver stiffness measurement may be useful to exclude or to confirm the presence of significant hepatic fibrosis, or to diagnose cirrhosis in chronic HBV patients. Nevertheless, diagnosis accuracy and cut-off values to define the different liver fibrosis stages are not as well-established as those for HCV, and the existence of hepatic necro-inflammation with an elevated level of transaminases may overestimate the correct scoring of liver fibrosis. [...]
- Liver elastography can provide additional information, but its diagnostic usefulness and cutoff values for assessment of liver fibrosis are not as well established as in hepatitis C (B1).
The indication for treatment is the same for patients with HBeAg-positive and HBeAg-negative, and have to be based on the combination of the following three criteria:
1. ALT levels.
2. DNA- VHB levels
3. Hepatic lesion assessed by liver biopsy and/or elastometry.

Pubmed : 90148788