From the Research
Patients with chronic hepatitis B infection who have no evidence of cirrhosis on initial evaluation should undergo testing for liver fibrosis every 6-12 months, as recommended by the most recent and highest quality study 1. This typically involves liver function tests, complete blood count, and assessment of hepatitis B viral load. Imaging studies such as ultrasound should be performed annually to monitor for hepatocellular carcinoma development. Some key points to consider when monitoring these patients include:
- More frequent monitoring may be necessary for patients with elevated ALT levels, high viral load (HBV DNA >2000 IU/mL), or those over 40 years of age, as these factors increase the risk of disease progression 2.
- The monitoring schedule allows clinicians to detect progression to fibrosis or cirrhosis early, enabling timely intervention with antiviral therapy such as entecavir or tenofovir 3.
- Regular monitoring is crucial because chronic hepatitis B can silently progress to advanced liver disease, and early detection of fibrosis progression can significantly improve outcomes through appropriate treatment adjustments 4.
- Transient elastography is a non-invasive method that can be used to stage liver fibrosis in patients with chronic hepatitis B, with a high diagnostic accuracy for detecting significant fibrosis and cirrhosis 1, 2, 3, 4.