1 Liver Unit University of Auckland.
2 Director Transplant Institute, Center for Liver Diseases, University of Chicago Biological Sciences.
3 Department of Medicine, University Malaya Medical Centre.
4 Medicine, University of Santo Tomas Hospital.
5 Department of Gastroenterology and Hepatobiliary Medicine, Defense Services Medical Academy, Myanmar.
6 Hepatology, Medic Medical Center, 254 Hoa Hao St-Dist 10-HCM City, Vietnam.
7 Department of Medicine, Cardinal Santos Medical Center, Mandaluyong, Metro Manila, Philippines.
8 Liver Transplantation team, Ciptomangunkusumo Hospital, Jakarta Indonesia.
9 Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
10 Faculty of Medicine and Health, University of Sydney, NSW, Australia.
11 Universitas Hasanuddin, Makassar, Indonesia.
12 Department of Gastroenterology Kalinga Institute of Medical Sciences, KIIT University, Chandrasekharpur, Bhubaneswar, Odisha.
13 Infectious Disease Center, Peking University Health Science Center, Beijing, 100191, China.
14 Department of Gastroenterology, LTM Medical College & Sion Hospital, Mumbai.
15 Gastroenterology & Hepatology, Max Smart Super Specialty Hospital, Saket.
16 Clinical / Transplant Hepatology Institute of Digestive &, Hepatobiliary Sciences Medanta, The Medicity.
17 Meerut Medical Centre.
18 Gastroenterologist, Associate Prof Liver Clinic Regional Institute of Sciences, Imphal.
19 Section of Hepatology Institute of Digestive and Liver Diseases, St. Luke's Medical Center, Philippines.
20 Department Liver Center, Department International graduate program in Medicine (IGPM) Institution Ulaanbaatar, Mongolia.
21 College of medicine, Taipei medical university, Taipei, Taiwan.
22 Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
23 Gastroenterology Unit, Department of Medicine Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
24 Gastroentero Hepatology Internal Medicine, Dr Kariadi Hospital, Medical Faculty, Diponegoro University, Jl Dr Sutomo 16, Semarang, Indonesia.
25 Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital Jalan Diponegoro, Jakarta, Indonesia.
26 Department of Hepatobiliary, University of Indonesia.
27 Department of Internal Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Hepatobiliary Division; Dr, Jakarta.
28 Myanmar Liver Foundation; Liver Foundation, Yangon, Myanmar.
29 Department of Hepatology, Yangon General Hospital, University of Medicine, Yangon, Myanmar.
30 Medical Affairs, Mylan Pharmaceuticals Private Limited.
Asia has an intermediate-to-high prevalence of and high morbidity and mortality from hepatitis B virus (HBV) infection. Optimization of diagnosis and initiation of treatment is one of the crucial strategies for lowering disease burden in this region. Therefore, a panel of 24 experts from 10 Asian countries convened, and reviewed the literature, to develop consensus guidance on diagnosis and initiation of treatment of HBV infection in resource-limited Asian settings. The panel proposed 11 recommendations related to diagnosis, pre-treatment assessment, and indications of therapy of HBV infection, and management of HBV-infected patients with co-infections. In resource-limited Asian settings, testing for hepatitis B surface antigen may be considered as the primary test for diagnosis of HBV infection. Pre-treatment assessments should include tests for complete blood count, liver and renal function, hepatitis B e-antigen (HBeAg), anti-HBe, HBV DNA, co-infection markers, and assessment of severity of liver disease. Non-invasive tests such as AST-to-platelet ratio index, fibrosis score 4, or transient elastography may be used as alternatives to liver biopsy for assessing disease severity. Considering the high burden of HBV infection in Asia, the panel adopted an aggressive approach, and recommended initiation of antiviral therapy in all HBV-infected, compensated or decompensated cirrhotic individuals with detectable HBV DNA levels, regardless of HBeAg status or alanine transaminase levels. The panel also developed a simple algorithm for guiding the initiation of treatment in non-cirrhotic, HBV-infected individuals. The recommendations proposed herein, may help guide clinicians, to optimize the diagnosis and improvise the treatment rates for HBV infection in Asia.