Staging of hepatitis B virus carriers based on HBV markers and cancer risk

A system to assist in the selection of appropriate antiviral treatment

Abstract

The clinical manifestations of hepatitis B virus (HBV) carrier state vary and are difficult to be objectively determined due to the lack of a clear staging system (criteria). We therefore devised an HBV carrier staging system based on HBV markers, ALT level, age, and cancer risk and also examined clinical treatments based on this staging system. We determined each stage as follows, stage 0 is HBe antigen-positive asymptomatic carriers with persistently normal ALT values, stage I is HBe antigen-positive carriers with abnormal ALT values and 10^7.6copies/ml and moreof HBV-DNA (younger patients: stage Ia; older patients: stage Ib), stage II is HBe antigen-positive carriers with abnormal ALT values and less than 10^7.6copies/ml of HBV-DNA (younger patients: stage IIa; older patients: stage IIb), stage III is HBe antigen-negative carriers with 10⁵copies/ml and more of HBV-DNA, stage IV is HBe antigen-negative carriers with less than 10⁵copies/ml of HBV-DNA, and stage V is carriers who no longer have HBs antigens. We believe that this staging system is useful for understanding HBV carrier stage that is related to the proper selection of clinical treatment.