HBsAg⁺ > 6 months

Serum HBV DNA > 2000 IU/mL (10⁴ copies/mL)

Persistent or intermittent elevation in ALT/AST levels

Liver biopsy showing chronic hepatitis

HBsAg⁺ > 6 months

HBeAg⁻, anti-HBe+

Serum HBV DNA < 2000 IU/mL

Persistently normal ALT/AST levels

Liver biopsy confirms absence of significant hepatitis

Previous known history of acute or chronic hepatitis B or the presence of anti-HBc ± anti-HBs

HBsAg⁻

Undetectable serum HBV DNA

Reappearance of active liver disease in a person known to have the inactive HBsAg carrier state or resolved hepatitis B