This AASLD 2018 Hepatitis B Guidance is intended to complement the AASLD 2016 Practice Guidelines for Treatment of Chronic Hepatitis B (1) and update the previous hepatitis B virus (HBV) guidelines from 2009. The 2018 updated guidance on chronic hepatitis B (CHB) includes (1) updates on treatment since the 2016 HBV guidelines (notably the use of tenofovir alafenamide) and guidance on (2) screening, counseling, and prevention;(3) specialized virological and serological tests;(4) monitoring of untreated patients; and (5) treatment of hepatitis B in special populations, including persons with viral coinfections, acute hepatitis B, recipients of immunosuppressive therapy, and transplant recipients. The AASLD 2018 Hepatitis B Guidance provides a data-supported approach to screening, prevention, diagnosis, and clinical management of patients with hepatitis B. It differs from the published 2016 AASLD guidelines, which conducted systematic reviews and used a multidisciplinary panel of experts to rate the quality (level) of the evidence and the strength of each recommendation using the Grading of Recommendations Assessment, Development and Evaluation system in support of guideline recommendations.(1-4) In contrast, this guidance document was developed by consensus of an expert panel, without formal systematic review or use of the Grading of Recommendations Assessment, Development, and Evaluation system. The 2018 guidance is based upon the following:(1) formal review and analysis of published literature on the topics;(2) World Health Organization guidance on prevention, care, and treatment of CHB (5); and (3) the authors’ experience in acute hepatitis B and CHB. Intended for use by health care providers, this guidance identifies preferred approaches to the diagnostic, therapeutic, and preventive aspects of care for patients with CHB. As with clinical practice guidelines, it provides general guidance to optimize the care of the

Abbreviations: AFP, alpha-fetoprotein; ALT, alanine aminotransferase; anti-HBc, antibody to hepatitis B core antigen; anti-HBe, antibody to hepatitis B e antigen; anti-HBs, antibody to hepatitis B surface antigen; ARVT, antiretroviral therapy; AST, aspartate aminotransferase; cccDNA, covalently closed circular DNA; CHB, chronic hepatitis B; DAA, direct-acting antiviral; HBeAg, hepatitis B e antigen; HBIG, hepatitis B immune globulin; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HCWs, health care workers; HDV, hepatitis D virus; HIV, human immunodeficiency virus; IFN, interferon; IFN-a, interferon-alfa; NA, nucleos (t) ide analogue; peg-IFN, peginterferon; peg-IFN-a, pegylated interferon-alfa; qHBsAg, quantitative hepatitis B surface antigen; TAF, tenofovir alafenamide; TDF, tenofovir disoproxil fumarate; ULN, upper limits of normal; US, ultrasonography.