Progression of Untreated Minimally Active Chronic HBV Infection Compared to Inactive Infection

Nucleos(t)ide analogs (NUCs) are recommended when both are fulfilled in the absence of hepatocellular carcinoma (HCC) or cirrhosis; (1) elevated serum hepatitis B virus (HBV)-DNA (≥20,000 IU/mL for hepatitis B e antigen-positive chronic hepatitis B [CHB] or ≥2000 IU/mL for hepatitis B e antigen-negative CHB) and (2) serum alanine aminotransferase ≥2× upper limit of normal.¹ Therefore, many patients still remain untreated. Such untreated patients have so called "minimally active CHB," where serum HBV-DNA is persistently >2000 IU/mL and other parameters for NUCs are below the criteria.² There have been little data concerning their prognosis.