2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T1233,Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death in patients with cirrhosis. Although advancements in surgical, locoregional, and systemic therapies have improved outcomes for patients with early-stage HCC, most cases are diagnosed at later stages due to both the limitations of currently recommended surveillance modalities and their underuse, with fewer than 1 in 4 patients with cirrhosis receiving surveillance for this tumor. Current guidelines recommend semiannual surveillance with ultrasound and α-fetoprotein, but this strategy has suboptimal sensitivity, and alternative imaging techniques (eg, computed tomography and magnetic resonance imaging) have their own risks and challenges with implementation. HCC surveillance has established benefits in certain at-risk populations, including patients with cirrhosis (of any etiology) and selected patients with chronic hepatitis B virus. The burden of HCC is rising most rapidly among patients with nonviral liver diseases, including metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease, among whom the annual incidence rate of HCC is significantly lower than was previously observed in patients with viral hepatitis. This underscores the need for better biomarker and risk-stratification tools to detect HCC earlier and improve surveillance efficiency, although integrating them into routine clinical practice presents a significant challenge. This American Gastroenterological Association (AGA) Clinical Practice Update aims to provide Best Practice Advice on emerging strategies for HCC risk stratification and surveillance. This Expert Review was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on this topic of high clinical importance to the AGA membership and underwent internal peer review by the Clinical Practice Updates Committee and external review procedures through the standard review process for Gastroenterology. These Best Practice Advice statements were drawn from a review of the published literature and from expert opinion. Because a systematic review was not performed, these Best Practice Advice statements do not carry formal ratings of the quality of available evidence or the strength of the presented advice. Best Practice Advice Statements BEST PRACTICE ADVICE 1: The best strategy for reducing hepatocellular carcinoma morbidity and mortality is to prevent cirrhosis. These strategies include vaccination and treatment of viral hepatitis (eg, hepatitis C virus and hepatitis B virus), recognizing and treating alcohol use disorder, managing metabolic syndrome, and addressing liver diseases at early stages. BEST PRACTICE ADVICE 2: The preferred current surveillance strategy for patients at risk of hepatocellular carcinoma is semiannual ultrasound and α-fetoprotein in combination. The benefits of surveillance include a higher likelihood of detecting early-stage hepatocellular carcinoma, access to curative therapy, and improved survival. BEST PRACTICE ADVICE 3: Among patients without cirrhosis, only a subset of those with chronic hepatitis B virus should undergo hepatocellular carcinoma surveillance; surveillance is not advised for those without cirrhosis from other etiologies due to the low annual incidence rate. BEST PRACTICE ADVICE 4: Although the benefits of hepatocellular carcinoma surveillance are well established, it is important for clinicians to consider the potential physical, psychological, and financial harms associated with the process. BEST PRACTICE ADVICE 5: Several novel blood-based biomarkers, such as GALAD, and radiologic biomarkers are undergoing clinical validation. Some are already commercially available, but evidence is insufficient to support their use in routine hepatocellular carcinoma surveillance. These assays should not replace guideline-recommended tests, although their accessibility and potential cost-effectiveness may support broader use once sufficiently validated. BEST PRACTICE ADVICE 6: Multicancer blood-based biomarker detection panels should not be used in the screening or surveillance of patients at risk for hepatocellular carcinoma. BEST PRACTICE ADVICE 7: Many hepatocellular carcinoma risk-stratification scores exist for patients with cirrhosis. However, few scores have undergone sufficient validation to support their use in clinical practice. BEST PRACTICE ADVICE 8: Among patients with chronic hepatitis B virus infection without cirrhosis, PAGE-B and REAL-B scores can stratify patients based on their future risk of hepatocellular carcinoma.31:T582,Monotherapy with a nucleos(t)ide analogue (NA), namely entecavir and tenofovir, represents the mainstay of hepatitis B virus (HBV) treatment, which achieves potent viral suppression and subsequently improved major outcomes, but it rarely leads to functional cure (i.e. 10-year cumulative rate of <3%). Current guidelines recommend NA discontinuation in all chronic hepatitis B patients who achieve HBV surface antigen (HBsAg) loss. Before HBsAg loss, NA discontinuation is recommended with caution only in non-cirrhotics with normal ALT who have remained in long-term on-therapy remission for various periods depending on their initial HBeAg status and agree to close post-treatment monitoring. This review explores the current landscape of the concept of NA discontinuation, examining benefits, risks, criteria for stopping, and patient selection and monitoring according to international guidelines, and biomarkers that may be helpful in decision-making. In the absence of novel antivirals leading to HBsAg clearance, accumulating data suggests that stopping NA therapy in carefully selected HBeAg negative patients may increase the probability of HBsAg loss and reduce long-term treatment burden, eventually improving patients' outcome. However, there are risks of post-treatment relapses and flares that need to be considered, while other critical parameters should be fitted to tailor patient selection.32:T4d6,Accumulating data related to prevention, surveillance and treatment of chronic hepatitis B (CHB) provided the impetus for this updated guideline, using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. The guideline was developed in compliance with the National Academy of Medicine standards. The guideline panel developed structured questions following the Population, Intervention Comparison, Outcomes (PICO) framework. The panel addressed 6 PICO questions covering prevention (maternal to infant transmission and horizontal transmission), surveillance for liver cancer (among hepatitis B surface antigen positive (HBsAg) persons co-infected with hepatitis C virus, hepatitis D virus and/or human immunodeficiency viruses and after HBsAg loss) and treatment (HBsAg positive persons in immune-tolerant or indeterminate phases as well as withdrawal of antiviral therapy), providing evidence-based recommendations on these topics. Four systematic reviews of the literature were conducted, and two existing systematic reviews were utilized to support the recommendations in this practice guideline. This evidence-based guideline provides updated recommendations to optimize the care of persons with CHB.33:T696, Background and Aims: Accumulating data related to prevention, surveillance and treatment of chronic hepatitis B (CHB) provided the impetus for this updated guideline, using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Methods: The guideline was developed in compliance with the National Academy of Medicine standards. The guideline panel developed structured questions following the Population, Intervention Comparison, Outcomes (PICO) framework. The panel addressed 6 PICO questions covering prevention (maternal to infant transmission and horizontal transmission), surveillance for liver cancer (among hepatitis B surface antigen positive (HBsAg) persons co-infected with hepatitis C virus, hepatitis D virus and/or human immunodeficiency viruses and after HBsAg loss) and treatment (HBsAg positive persons in immune-tolerant or indeterminate phases as well as withdrawal of antiviral therapy), providing evidence-based recommendations on these topics. Four systematic reviews of the literature were conducted, and two existing systematic reviews were utilized to support the recommendations in this practice guideline. Conclusions: This evidence-based guideline provides updated recommendations to optimize the care of persons with CHB. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Chronic Hepatitis B: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Chronic Hepatitis B (condition). Clinician-written summaries and actionable practice insights. 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Patients **with cirrhosis** had annual HCC incidence of 0.43–0.62% regardless of age at seroclearance. Patients **without cirrhosis** who cleared HBsAg before age 50 had an annual incidence of 0.03% — identical to the general population. No HCC occurred over 15 years of follow-up among 1,317 women without cirrhosis who cleared HBsAg before age 50.","limitations":"- Single-territory (Hong Kong) database; findings may not generalize to non-Asian or lower-prevalence populations.\n- Observational design limits causal inference; unmeasured confounders (e.g., alcohol use, metabolic risk) may affect HCC risk estimates.\n- HBsAg seroclearance confirmation methods and surveillance protocols varied over a 22-year period.","practice_takeaway":"Consider discontinuing routine HCC surveillance in women without cirrhosis who clear HBsAg before age 50, and in men without cirrhosis who clear before age 40, as their risk is comparable to the general population. Patients with cirrhosis at the time of seroclearance should continue structured surveillance regardless of age."}},{"doi":"10.1016/j.jhep.2026.06.038","pmid":"42409322","title":"Declining but persistent hepatocellular cancer risk beyond 10 years of entecavir or tenofovir in chronic hepatitis B: Results of the PAGE-B cohort","journal_title":"Journal of Hepatology","journal_issn":"0168-8278","published_at":"2026-07-06T00:00:00.000Z","url":"https://doi.org/10.1016/j.jhep.2026.06.038","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-14T13:24:04.774Z","updated_at":"2026-07-14T13:24:04.774Z","tags":[{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"condition","value":"Hepatocellular Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"generic","value":"entecavir","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"generic","value":"tenofovir","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"modality","value":"Nucleoside/Nucleotide Analogue","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"sample_size","value":"n=1644","value_numeric":1644},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"warning","value":"Study design is observational with no randomized comparator; causal inference regarding treatment effects is limited.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"warning","value":"The cohort is exclusively Caucasian (PAGE-B cohort); results may not apply to Asian or African CHB populations, who carry the majority of the global disease burden and have different baseline HCC risk profiles.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.06.038","tag_type":"warning","value":"The paper's DOI and publication date (July 2026) are future-dated relative to most current literature databases—confirm availability before citing.","value_numeric":null}],"summaries":{"what_studied":"Long-term outcomes (HCC incidence, survival, HBsAg loss) in 1,644 Caucasian patients with chronic hepatitis B (CHB) treated with entecavir or tenofovir, with 903 followed beyond year 10 (mean 14±2 years) in the PAGE-B cohort.","key_result":"HCC cumulative incidence was 10.9% at 10 years and 13.2% at 15 years, but the HCC incidence rate fell significantly after year 10 (1.25 → 0.55/100 person-years, P<0.001). HBsAg loss rates actually increased after year 10 (0.94 → 1.42/100 PYs, P=0.025), reaching 14.3% cumulative incidence at 15 years. HCC was the main driver of mortality.","limitations":"Cohort is exclusively Caucasian, limiting generalizability to Asian or African populations where CHB epidemiology and HCC risk differ. No control arm; patients who did not reach year 10 (n=741) differ systematically from those who did, introducing potential selection bias despite inverse probability weighting.","practice_takeaway":"Even after 10 years of entecavir or tenofovir, CHB patients—especially older patients and those with low baseline platelets or diabetes—remain at meaningful HCC risk and should continue surveillance. HBsAg loss rates modestly increase after year 10, so long-term NA therapy should not be prematurely stopped in HBsAg-positive patients."}},{"doi":"10.1016/j.jhep.2026.05.026","pmid":"42342081","title":"Regression of liver cirrhosis","journal_title":"Journal of Hepatology","journal_issn":"0168-8278","published_at":"2026-06-24T00:00:00.000Z","url":"https://doi.org/10.1016/j.jhep.2026.05.026","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-02T13:33:12.104Z","updated_at":"2026-07-02T13:33:12.104Z","tags":[{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"condition","value":"Alcohol-Associated Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"condition","value":"Chronic Hepatitis C","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"condition","value":"Hepatocellular Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"condition","value":"Liver Cirrhosis","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatohepatitis","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"condition","value":"Portal Hypertension","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"generic","value":"aldafermin","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"generic","value":"efruxifermin","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"generic","value":"fazirsiran","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"generic","value":"obeticholic acid","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"generic","value":"pegbelfermin","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"generic","value":"resmetirom","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"generic","value":"selonsertib","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"modality","value":"Antiviral Therapy","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"modality","value":"CAR T Cell Therapy","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"modality","value":"Cell Therapy","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"modality","value":"Digital Pathology / Artificial Intelligence","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"modality","value":"FGF21 Analogue","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"modality","value":"FXR Agonist","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"modality","value":"RNA Interference","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"warning","value":"No sample size tag applied — this is a review article with no single primary study population.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"warning","value":"Several cited trials and data points are from 2025–2026, some of which may be preliminary or not yet fully peer-reviewed at the time of this review's publication.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"warning","value":"Sex breakdown of study populations is not reported in this review.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.05.026","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the reframing of cirrhosis as a dynamic and modifiable state, but no single new therapy has been approved; clinical practice change is driven by the conceptual framework and monitoring recommendations rather than a new drug.","value_numeric":null}],"summaries":{"what_studied":"This narrative review synthesizes current evidence on cirrhosis regression across pathological, mechanistic, and clinical domains — covering cellular reprogramming of the fibrotic niche, AI-assisted digital pathology, antifibrotic drug trials (especially MASH-related cirrhosis), and non-invasive monitoring tools for regression and recompensation.","key_result":"Cirrhosis is a dynamic, potentially modifiable state: sustained aetiological control (antiviral therapy, abstinence, bariatric surgery) induces measurable architectural remodelling and reduces portal hypertension, decompensation risk, and mortality — but regression is often incomplete. Recent phase 2 monotherapy trials in MASH cirrhosis (efruxifermin, semaglutide, aldafermin, pegbelfermin, obeticholic acid) all failed to meet primary histological endpoints. Approximately one-third of patients with prior decompensation achieve recompensation after aetiological control. HCC risk remains elevated even after viral eradication, reflecting epigenetic and microenvironmental 'memory'.","limitations":"- Review is narrative without systematic search or meta-analysis; no pooled effect sizes provided.\n- Most mechanistic data derive from rodent or single-cell models with limited direct validation in human cirrhosis regression.\n- No approved antifibrotic therapies exist; clinical translation of preclinical targets has been consistently disappointing.","practice_takeaway":"Treat the underlying cause aggressively — antiviral therapy, alcohol abstinence, or weight loss remains the most evidence-based strategy to induce cirrhosis regression and recompensation. Even after structural improvement, continue HCC surveillance, as oncogenic risk persists beyond histological normalisation."}},{"doi":"10.1016/j.cgh.2026.06.018","pmid":"42320551","title":"No impact of low-dose nivolumab addition to JNJ-73763989 on HBsAg declines in chronic hepatitis B: the OCTOPUS-1 study","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-06-19T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.06.018","source_score":10,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-27T13:27:45.086Z","updated_at":"2026-06-27T13:27:45.086Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"brand","value":"Opdivo","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"generic","value":"JNJ-73763989","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"generic","value":"nivolumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"modality","value":"Nucleos(t)ide Analog","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"modality","value":"PD-1 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"modality","value":"RNA Interference (siRNA)","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"sample_size","value":"n=37","value_numeric":37},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"warning","value":"HBsAg seroclearance at follow-up week 48 occurred in 1 participant (Arm 2); this post-primary-endpoint result should not be overinterpreted.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"warning","value":"JNJ-73763989 is also referred to as JNJ-3989 in the paper; these are the same investigational siRNA agent.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"warning","value":"The brand name 'Opdivo' is inferred for nivolumab but is not explicitly stated in the abstract; the paper only references the generic name.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.018","tag_type":"warning","value":"The study is phase 2 with only 37 participants — findings should be interpreted with caution given very limited statistical power.","value_numeric":null}],"summaries":{"what_studied":"Open-label, randomized phase 2 trial (OCTOPUS-1) evaluating whether adding low-dose nivolumab (0.3 mg/kg; 1 or 3 doses) to JNJ-73763989 (siRNA) plus nucleos(t)ide analog (NA) improved HBsAg seroclearance in HBeAg-negative, virologically suppressed chronic hepatitis B (CHB) adults over a 24-week treatment period with 48-week follow-up.","key_result":"No participant achieved the primary endpoint of HBsAg seroclearance at follow-up week 24; only 1/37 (Arm 2) achieved seroclearance at follow-up week 48. Both arms showed robust HBsAg declines at week 24 (Arm 1: −2.01 log10 IU/mL; Arm 2: −2.10 log10 IU/mL), but a cross-study comparison with REEF-1 showed no added benefit from the loading dose or nivolumab.","limitations":"- Very small sample (n=37), limiting power to detect differences between arms.\n- Open-label design without a placebo-controlled arm within the same trial.\n- No clear mechanistic link found between HBV-specific T-cell activity and HBsAg response, leaving the basis for PD-1 augmentation uncertain.","practice_takeaway":"Adding low-dose nivolumab to JNJ-3989 + NA did not meaningfully improve HBsAg seroclearance rates in virologically suppressed, HBeAg-negative CHB patients, though the combination appeared safe. Clinicians should not expect checkpoint inhibitor augmentation at this dose to close the gap to functional cure in this population."}},{"doi":"10.1080/14787210.2026.2690003","pmid":"42298392","title":"Hepatitis B in pregnancy and breastfeeding: current approaches to prophylaxis and treatment","journal_title":"Expert Review of Anti-infective Therapy","journal_issn":"1478-7210","published_at":"2026-06-15T00:00:00.000Z","url":"https://doi.org/10.1080/14787210.2026.2690003","source_score":13,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-20T13:24:54.616Z","updated_at":"2026-06-20T13:24:54.616Z","tags":[{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"condition","value":"Mother-to-Child Transmission of Hepatitis B","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"generic","value":"tenofovir alafenamide","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"generic","value":"tenofovir disoproxil fumarate","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"modality","value":"Hepatitis B Immunoglobulin","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"modality","value":"Hepatitis B Vaccine","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"modality","value":"Nucleotide Reverse Transcriptase Inhibitor","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"warning","value":"Full text was not accessible; structured data extracted from abstract, article highlights, and publisher page only — detailed efficacy numbers and study quality assessments could not be verified.","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"warning","value":"One lead author discloses an institutional research grant from Gilead Sciences, which markets tenofovir-based therapies discussed favorably in this review; readers should weigh potential influence on conclusions.","value_numeric":null},{"paper_doi":"10.1080/14787210.2026.2690003","tag_type":"warning","value":"Study design tagged as 'Narrative Review' based on article type labeling; no systematic search methodology or PRISMA reporting was confirmed in the available text.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates current strategies for preventing and managing hepatitis B virus (HBV) mother-to-child transmission (MTCT), covering maternal antiviral prophylaxis with TDF and TAF, HBIG-free approaches, novel vaccines, postpartum flare management, and breastfeeding safety during antiviral therapy.","key_result":"Maternal antiviral prophylaxis (TDF or TAF) is effective and safe for reducing MTCT, particularly when maternal HBV DNA exceeds 200,000 IU/mL; HBIG-free strategies are viable; and breastfeeding is considered safe during TDF or TAF therapy. Vaccination plus HBIG reduces MTCT but faces cost and access barriers in resource-limited settings.","limitations":"- Full text was not available; conclusions are drawn from the abstract, highlights, and publisher page only.\n- No original patient data are presented — this is a narrative review without meta-analytic pooling or quality assessment of included studies.\n- Conflict of interest noted: one author receives institutional research funding from Gilead Sciences, a manufacturer of tenofovir-based therapies.","practice_takeaway":"Offer antiviral prophylaxis (TDF or TAF) to pregnant women with HBV DNA >200,000 IU/mL, in addition to infant immunoprophylaxis. Breastfeeding need not be withheld in mothers maintained on TDF or TAF."}},{"doi":"10.1097/hep.0000000000001804","pmid":"42263224","title":"HBsAg seroclearance further reduces hepatocellular carcinoma but not hepatic decompensation in patients with cirrhosis and complete viral suppression","journal_title":"Hepatology","journal_issn":"0270-9139","published_at":"2026-06-08T00:00:00.000Z","url":"https://doi.org/10.1097/hep.0000000000001804","source_score":13,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-14T13:34:51.583Z","updated_at":"2026-06-14T13:34:51.583Z","tags":[{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"condition","value":"Cirrhosis","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"condition","value":"Hepatocellular Carcinoma","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"generic","value":"entecavir","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"generic","value":"tenofovir","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"modality","value":"Nucleoside/Nucleotide Analogue","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"sample_size","value":"n=5149","value_numeric":5149},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"warning","value":"Brand names for entecavir (Baraclude) and tenofovir products (Viread, Vemlidy) were not specified in the paper and are therefore not tagged.","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"warning","value":"The HBsAg seroclearance group was small (n=161), so the null result for hepatic decompensation may reflect insufficient statistical power rather than a true absence of effect.","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001804","tag_type":"warning","value":"The 'practice_changing' impact flag is applied with caution — the finding supports HBsAg loss as a therapeutic target, but the observational design and small seroclearance group limit definitive conclusions.","value_numeric":null}],"summaries":{"what_studied":"In NA-treated adults with chronic hepatitis B (CHB) and cirrhosis who achieved complete viral suppression on entecavir or tenofovir, this cohort study compared the risk of HCC and hepatic decompensation between those who also achieved HBsAg seroclearance vs. those with viral suppression alone, using 1-year landmark analysis over a median follow-up of ~4 years.","key_result":"HBsAg seroclearance was associated with a significantly lower risk of HCC (adjusted subdistribution HR 0.37, 95% CI 0.15–0.91; p=0.030) compared to complete viral suppression alone — HCC developed in 3.1% (5/161) vs. 9.1% (456/4,988) of patients. No difference was seen in hepatic decompensation events (asHR 1.01, 95% CI 0.52–1.95; 6.5% vs. 7.0%).","limitations":"- HBsAg seroclearance group was small (n=161), limiting statistical power, especially for hepatic decompensation outcomes.\n- Observational design cannot exclude residual confounding despite adjustment.\n- Generalizability may be limited to populations with similar cirrhosis burden and NA treatment patterns.","practice_takeaway":"For cirrhotic CHB patients on entecavir or tenofovir, achieving HBsAg seroclearance — beyond viral suppression alone — roughly halves the risk of HCC, but does not reduce hepatic decompensation. This supports HBsAg loss as a meaningful treatment target for HCC prevention in cirrhotic patients."}},{"doi":"10.1370/afm.250581","pmid":"42191372","title":"Impact of Epic Care Gaps on Hepatitis B Care Retention","journal_title":"The Annals of Family Medicine","journal_issn":"1544-1709","published_at":"2026-05-26T00:00:00.000Z","url":"https://doi.org/10.1370/afm.250581","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-28T13:24:33.285Z","updated_at":"2026-05-28T13:24:33.285Z","tags":[{"paper_doi":"10.1370/afm.250581","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"condition","value":"Hepatocellular Carcinoma Surveillance","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"modality","value":"Electronic Health Record Clinical Decision Support","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"study_design","value":"Retrospective Pre-Post Quality Improvement Study","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"warning","value":"Sample size is not explicitly reported in the paper; the total number of CHB patients included could not be tagged.","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"warning","value":"Study design is a single-site pre-post quality improvement evaluation—no randomization or concurrent control group—so the 'practice_changing' flag reflects the magnitude of the result, not the strength of the evidence design.","value_numeric":null},{"paper_doi":"10.1370/afm.250581","tag_type":"warning","value":"The paper is classified as an 'Innovations in Primary Care' brief, which may limit the depth of methodological detail available for critical appraisal.","value_numeric":null}],"summaries":{"what_studied":"A single Epic EHR 'care gap' prompt alerting rooming staff when a chronic hepatitis B (CHB) patient had not received an HBV DNA level in the prior 12 months was evaluated at an urban safety-net primary care residency clinic in St. Paul, MN, comparing retention rates in the 14 months before (April 2023) and after (May 2024–August 2025) activation.","key_result":"Baseline retention for patients not requiring HCC surveillance was 34.1%; after the care gap activated, it rose ~17 percentage points to 51.2% by August 2025, surpassing the upper statistical control limit. Overall CHB retention reached 27%, outperforming national rates of 11–21%.","limitations":"Single-site retrospective evaluation at one urban safety-net clinic limits generalizability. The prompt addressed only HBV DNA testing—not ALT, ultrasound, or AFP—so full guideline-concordant surveillance was not systematically prompted. No control group; improvement is assessed via statistical process control charts rather than a comparative trial.","practice_takeaway":"A single EHR care gap prompt embedded in routine rooming staff workflow can meaningfully improve CHB monitoring without extra outreach effort. Clinics using Epic can replicate this by building a simple, automated HBV DNA care gap into their existing 'every patient, every visit' screening workflows."}},{"doi":"10.1016/s2468-1253(26)00058-0","pmid":"42173110","title":"The small interfering RNA imdusiran as single and multiple doses in healthy, randomised individuals and non-randomised individuals with chronic hepatitis B (AB-729–001): a phase 1a/b trial","journal_title":"The Lancet Gastroenterology & Hepatology","journal_issn":"2468-1253","published_at":"2026-05-22T00:00:00.000Z","url":"https://doi.org/10.1016/s2468-1253(26)00058-0","source_score":11,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-29T13:23:14.274Z","updated_at":"2026-05-29T13:23:14.274Z","tags":[{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"generic","value":"imdusiran","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"modality","value":"RNA Interference (siRNA)","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"sample_size","value":"n=83","value_numeric":83},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"study_design","value":"Phase 1 Clinical Trial","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"warning","value":"Level of evidence assigned as '2' reflecting a well-designed phase 1 randomized (part 1) plus non-randomized (parts 2–3) trial; some may classify phase 1 studies differently.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"warning","value":"Part 1 enrolled 100% male participants; sex balance improved in parts 2 and 3 but was not equal, which may affect generalizability of safety data.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00058-0","tag_type":"warning","value":"The abstract does not report efficacy endpoints (HBsAg decline, HBV DNA levels, or immune response data), so antiviral activity conclusions cannot be extracted.","value_numeric":null}],"summaries":{"what_studied":"This phase 1a/b trial (AB-729-001) evaluated the safety, tolerability, and antiviral activity of imdusiran — an N-acetylgalactosamine-conjugated siRNA — as single doses (60, 180, 360 mg) in healthy adults and single or multiple doses (60–180 mg every 4, 8, or 12 weeks for up to 48 weeks) in adults with chronic hepatitis B (HBeAg-positive or negative, on or off nucleos[t]ide analogue therapy).","key_result":"No participants discontinued imdusiran due to an adverse event across all 83 enrolled participants (parts 1–3). All treatment-emergent adverse events were grade 1; no deaths occurred. No dose-related trends in adverse events were observed. The most common treatment-related events were injection-site reactions (pain, erythema, bruising) and transient ALT elevations.","limitations":"- No efficacy outcomes (e.g., HBsAg decline, HBV DNA suppression) are reported in this abstract, limiting interpretation of antiviral benefit.\n- Part 1 enrolled only male participants, restricting generalizability.\n- Open-label design in parts 2 and 3 introduces potential bias in adverse event reporting.","practice_takeaway":"Imdusiran appears safe and well tolerated across a range of single and multiple doses in both healthy individuals and patients with chronic hepatitis B, with only grade 1 adverse events and no treatment discontinuations. Clinicians should await efficacy data from later-phase trials before considering this agent on the path to HBsAg functional cure."}},{"doi":"10.1111/liv.70665","pmid":"42059263","title":"Emergency Department Opt‐Out Testing for Hepatitis B: A Two‐Year\n UK\n Multicentre Evaluation of Outcomes Across Seven Sites","journal_title":"Liver International","journal_issn":"1478-3223","published_at":"2026-04-30T00:00:00.000Z","url":"https://doi.org/10.1111/liv.70665","source_score":4,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:55.557Z","updated_at":"2026-05-07T22:50:55.557Z","tags":[{"paper_doi":"10.1111/liv.70665","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"condition","value":"Hepatitis D","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"condition","value":"Hepatocellular Carcinoma","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"generic","value":"hepatitis B surface antigen testing","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"modality","value":"Blood-Borne Virus Opt-Out Screening","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"modality","value":"Nucleoside Analogue","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"sample_size","value":"n=1399","value_numeric":1399},{"paper_doi":"10.1111/liv.70665","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"study_design","value":"Multicentre Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"warning","value":"Linkage-to-care rates vary substantially depending on the follow-up window used (97% over full study vs. ~38% at 4 weeks in a separate UKHSA interim report) — clinicians should note the 90-day mean time to assessment when benchmarking.","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"warning","value":"Sample size tag reflects combined ED (n=983) and non-ED (n=416) cohorts; the two groups were not always compared over identical time windows.","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"warning","value":"Seven individuals with HDV co-infection were identified but outcomes for this subgroup were not separately reported.","value_numeric":null},{"paper_doi":"10.1111/liv.70665","tag_type":"warning","value":"The study is a service evaluation, not a randomised trial; confounding by indication may affect comparisons between ED and non-ED cohorts.","value_numeric":null}],"summaries":{"what_studied":"A 2-year multicentre retrospective evaluation of ED opt-out HBsAg testing across seven London sites (April 2022–March 2024), comparing 983 HBsAg-positive adults identified via ED testing to 416 referred through non-ED pathways, with a 6-month follow-up period.","key_result":"ED opt-out testing produced a **107% increase** in HBV assessments. Of 983 positives, 90.2% were contactable and 97% (660/679) of those needing care were linked to specialist services. Among assessed patients: 16.4% had significant fibrosis (LSM ≥7.0 kPa), 20.5% had viral load >2000 IU/mL, and 14.4% started nucleoside analogue therapy. Mean time to first assessment was **90 days**. ED patients were older (mean 51 vs. 47 years, p<0.001) and had lower viral loads (mean log₁₀ HBV DNA 2.08 vs. 2.78, p<0.001).","limitations":"- Socioeconomic status was not analysed, limiting understanding of equity impacts.\n- Outcomes for patients referred to non-local services or with equivocal results pending retest were not fully captured.\n- Non-ED comparison window was shorter in South West London (12 months) due to data system changes, introducing some asymmetry.","practice_takeaway":"ED opt-out HBsAg testing can more than double hepatitis B assessments and achieves very high linkage-to-care rates, but services must expect a ~3-month lag to first specialist review. A notable 35% of assessed patients already knew their diagnosis but were not in care — proactive re-engagement pathways are needed alongside new case-finding."}},{"doi":"10.1001/jamapediatrics.2026.1226","pmid":"42043807","title":"Impact of Removing the Universal Hepatitis B Birth-Dose Vaccination in the US","journal_title":"JAMA Pediatrics","journal_issn":"2168-6203","published_at":"2026-04-27T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13122499/","source_score":107,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:49:19.361Z","updated_at":"2026-05-07T22:49:19.361Z","tags":[{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"condition","value":"Hepatitis B Virus Infection","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"condition","value":"Neonatal Hepatitis B","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"modality","value":"Hepatitis B Vaccine","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"sample_size","value":"n=3,659,289","value_numeric":3659289},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"study_design","value":"Compartmental Mathematical Model / Simulation Study","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"warning","value":"Level of evidence is rated 4 (modeling study) rather than higher-level experimental or observational evidence; uncertainty intervals are wide, particularly at low vaccination coverage scenarios.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"warning","value":"The ACIP policy change (December 2025) is very recent; this model uses pre-implementation assumptions and has not been validated against post-policy real-world data.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.1226","tag_type":"warning","value":"The compartmental model simulates a single US birth cohort — results reflect projected, not observed, infection counts.","value_numeric":null}],"summaries":{"what_studied":"A compartmental model simulated a US birth cohort (n=3,659,289) to estimate the impact of replacing universal hepatitis B virus (HBV) birth-dose vaccination with a targeted recommendation (shared decision-making for infants of HBsAg-negative mothers) on neonatal and chronic HBV infections.","key_result":"Under the current 86% maternal screening rate, universal birth-dose vaccination yielded a median of 1,292 neonatal HBV infections. Switching to a targeted recommendation added 628 infections (if unscreened-mother coverage fell to 10%, mirroring historical declines) or 69 infections (if coverage held at 80%). Offsetting excess infections would require screening 100,000–400,000+ additional pregnant individuals.","limitations":"Model is based on a simulated cohort rather than observed outcomes; parameter values are literature-derived with inherent uncertainty across 5,000 iterations; the study cannot account for real-world behavioral responses to the new ACIP policy as it was published before implementation data exist.","practice_takeaway":"Removing the universal hepatitis B birth dose is likely to increase neonatal HBV infections unless maternal screening rates rise sharply or vaccination of infants born to unscreened mothers stays high — outcomes that historical data suggest are unlikely. Clinicians should continue to advocate for universal birth-dose vaccination and complete maternal HBsAg screening."}},{"doi":"10.1053/j.gastro.2026.03.006","pmid":"42017860","title":"AGA Clinical Practice Update on Risk Stratification and Emerging Surveillance Strategies for Hepatocellular Carcinoma: Expert Review","journal_title":"Gastroenterology","journal_issn":"0016-5085","published_at":"2026-04-22T00:00:00.000Z","url":"https://doi.org/10.1053/j.gastro.2026.03.006","source_score":66,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-04-20","doi":"10.1053/j.gastro.2026.03.006","days":"30","issn":"0016-5085","rank":"6","field":"Clinical Medicine","score":"66","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1053/j.gastro.2026.03.006","title":"AGA Clinical Practice Update on Risk Stratification and Emerging Surveillance Strategies for Hepatocellular Carcinoma: Expert Review.","journal":"Gastroenterology","methods":"","results":"","abstract":"$30","keywords":["Biomarker","Liver Cancer","Prediction Models","Risk Scores","Screening","Surveillance"],"pubmed_id":"42017860","conclusions":"","publication_date":"2026-04-22T00:00:00"},"crossref":{"DOI":"10.1053/j.gastro.2026.03.006","URL":"https://doi.org/10.1053/j.gastro.2026.03.006","ISSN":["0016-5085"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S001650852600243X?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S001650852600243X?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["AGA Clinical Practice Update on Risk Stratification and Emerging Surveillance Strategies for Hepatocellular Carcinoma: Expert Review"],"author":[{"given":"Nicole E.","family":"Rich","sequence":"first","affiliation":[]},{"given":"Augusto","family":"Villanueva","sequence":"additional","affiliation":[]},{"given":"Jorge A.","family":"Marrero","sequence":"additional","affiliation":[]},{"given":"Fasiha","family":"Kanwal","sequence":"additional","affiliation":[]}],"funder":[{"id":[{"id":"10.13039/100000002","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher"},{"id":[{"id":"10.13039/100007316","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100007316","name":"National Cancer Institute Division of Cancer Prevention","award":["K08 CA259536"],"award-info":[{"award-number":["K08 CA259536"]}],"doi-asserted-by":"publisher"},{"id":[{"id":"10.13039/100007316","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100007316","name":"National Cancer Institute Division of Cancer Prevention","award":["1U01CA283931-01"],"award-info":[{"award-number":["1U01CA283931-01"]}],"doi-asserted-by":"publisher"}],"issued":{"date-parts":[[2026,4]]},"member":"78","prefix":"10.1053","source":"Crossref","volume":null,"created":{"date-time":"2026-04-15T09:20:21Z","timestamp":1776244821000,"date-parts":[[2026,4,15]]},"indexed":{"date-time":"2026-05-14T00:16:25Z","timestamp":1778717785573,"date-parts":[[2026,5,14]]},"license":[{"URL":"https://www.elsevier.com/tdm/userlicense/1.0/","start":{"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000,"date-parts":[[2026,4,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://www.elsevier.com/legal/tdmrep-license","start":{"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000,"date-parts":[[2026,4,1]]},"delay-in-days":0,"content-version":"tdm"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://linkinghub.elsevier.com/retrieve/pii/S001650852600243X"}},"subtitle":[],"assertion":[{"name":"publisher","label":"This article is maintained by","value":"Elsevier"},{"name":"articletitle","label":"Article Title","value":"AGA Clinical Practice Update on Risk Stratification and Emerging Surveillance Strategies for Hepatocellular Carcinoma: Expert Review"},{"name":"journaltitle","label":"Journal Title","value":"Gastroenterology"},{"name":"articlelink","label":"CrossRef DOI link to publisher maintained version","value":"https://doi.org/10.1053/j.gastro.2026.03.006"},{"name":"content_type","label":"Content Type","value":"article"},{"name":"copyright","label":"Copyright","value":"© 2026 American Gastroenterological Association Institute. 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study; level of evidence is assigned as 5 (expert opinion).","value_numeric":null}],"summaries":{"what_studied":"This AGA Clinical Practice Update (Expert Review) evaluates emerging strategies for HCC risk stratification and surveillance in at-risk populations, including patients with cirrhosis, chronic hepatitis B virus (HBV), metabolic dysfunction-associated steatotic liver disease (MASLD), and alcohol-associated liver disease (ALD), with 8 Best Practice Advice statements derived from literature review and expert opinion.","key_result":"Semiannual ultrasound + α-fetoprotein remains the preferred surveillance strategy; fewer than 1 in 4 patients with cirrhosis currently receive surveillance. Novel biomarkers (e.g., GALAD) and multicancer detection panels lack sufficient validation for routine use. PAGE-B and REAL-B scores can stratify HCC risk in non-cirrhotic chronic HBV patients.","limitations":"No systematic review was performed, so Best Practice Advice statements carry no formal evidence quality ratings or recommendation strength grades. The update does not address post-diagnosis management in depth.","practice_takeaway":"Use semiannual ultrasound + AFP for HCC surveillance in all patients with cirrhosis and selected chronic HBV patients without cirrhosis; do not substitute novel biomarker panels (including multicancer liquid biopsy panels) until further validation. In non-cirrhotic chronic HBV, PAGE-B or REAL-B scores can guide who warrants surveillance."}},{"doi":"10.1016/j.jhep.2026.03.030","pmid":"41921700","title":"Long-term outcomes after nucleos(t)ide analogue cessation in chronic hepatitis B – follow-up from the RETRACT-B cohort","journal_title":"Journal of Hepatology","journal_issn":"0168-8278","published_at":"2026-03-30T00:00:00.000Z","url":"https://doi.org/10.1016/j.jhep.2026.03.030","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-17T13:29:50.023Z","updated_at":"2026-06-17T13:29:50.023Z","tags":[{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"condition","value":"Hepatic Decompensation","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"condition","value":"Hepatocellular Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"modality","value":"Nucleoside/Nucleotide Analogue","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"sample_size","value":"n=2029","value_numeric":2029},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"warning","value":"No specific generic or brand drug names are listed; the study covers the NA drug class as a whole.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"warning","value":"Ten-year outcome estimates are modeled (median FU ~65 months), so long-tail projections carry uncertainty.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.03.030","tag_type":"warning","value":"The study design is described as extended follow-up from an existing cohort (RETRACT-B) with new patients added; this hybrid design sits between a prospective cohort and a registry study — classified as 'Prospective Cohort Study' but readers should note the mixed enrollment approach.","value_numeric":null}],"summaries":{"what_studied":"Long-term outcomes (up to 10 years) after stopping nucleos(t)ide analogues (NAs) in 2,029 HBeAg-negative, virally suppressed, HBsAg-positive chronic hepatitis B patients from a large global multiethnic cohort (RETRACT-B), stratified by HBsAg level at end of therapy.","key_result":"The 10-year off-treatment HBsAg loss rate was 17% overall, but varied sharply by baseline HBsAg: 52% for <100 IU/ml, 13% for 100–1,000 IU/ml, and 6% for ≥1,000 IU/ml; 59% of all patients required retreatment. Ten-year risks of flares, hepatocellular carcinoma (HCC), and decompensation were 30%, 3.9%, and 3.3%, respectively; cirrhosis history doubled decompensation risk (5.7% vs. 3.0%) and quintupled HCC risk (12% vs. 2.4%).","limitations":"- Median follow-up was ~65 months; 10-year estimates rely on extrapolation for a subset of patients.\n- Cohort is 81% Asian, limiting generalizability to other ethnicities.\n- Observational design with no comparator arm of continued NA therapy.","practice_takeaway":"Consider stopping NAs only in HBeAg-negative patients with HBsAg <100 IU/ml who can be strictly monitored — this group has a 52% chance of HBsAg loss and only a 28% retreatment rate at 10 years. 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not a clinical trial or systematic review.","value_numeric":null},{"paper_doi":"10.1080/14787210.2025.2611311","tag_type":"warning","value":"Specific stopping durations and monitoring protocols are referenced but not detailed in the abstract.","value_numeric":null},{"paper_doi":"10.1080/14787210.2025.2611311","tag_type":"warning","value":"The abstract lacks quantitative post-cessation outcomes (relapse, flare, HBsAg loss rates).","value_numeric":null}],"summaries":{"what_studied":"A narrative review of when to discontinue nucleos(t)ide analogue therapy (entecavir, tenofovir) in chronic hepatitis B, covering benefits, risks, stopping criteria, patient selection, monitoring, and potential biomarkers per international guidelines.","key_result":"Long-term NA monotherapy seldom achieves functional cure (10-year cumulative rate <3%). Guidelines endorse stopping after HBsAg loss; before HBsAg loss, discontinuation is advised only with caution in non-cirrhotics with normal ALT who have sustained on-therapy remission and agree to close post-treatment monitoring, and accumulating data suggest that stopping in carefully selected HBeAg-negative patients may increase HBsAg loss but carries risks of relapse and flares.","limitations":"Narrative (expert) review without new primary data; the abstract provides no quantitative rates of relapse, flares, or HBsAg loss after cessation. Details of selection criteria and monitoring schedules are not quantified here.","practice_takeaway":"Stop NAs after HBsAg loss per guidelines. Before HBsAg loss, consider cessation only in non-cirrhotic patients with normal ALT and long-term remission who can be closely monitored; in selected HBeAg-negative patients, stopping may raise HBsAg loss probability but requires vigilance for relapse and flares."}},{"doi":"10.1097/hep.0000000000001549","pmid":"41186418","title":"AASLD/IDSA Practice Guideline on treatment of chronic hepatitis B","journal_title":"Hepatology","journal_issn":"0270-9139","published_at":"2025-11-04T00:00:00.000Z","url":"https://doi.org/10.1097/hep.0000000000001549","source_score":87,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-11-06","doi":"10.1097/hep.0000000000001549","days":"30","issn":"0270-9139","rank":"2","field":"Clinical Medicine","score":"87","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1097/HEP.0000000000001549","title":"AASLD/IDSA Practice Guideline on treatment of chronic hepatitis B.","journal":"Hepatology (Baltimore, Md.)","methods":"","results":"","abstract":"$32","keywords":["antiviral discontinuation","grey zone","hepatocellular carcinoma","horizontal transmission","immune-tolerant","indeterminate","pregnancy","surveillance"],"pubmed_id":"41186418","conclusions":"","publication_date":"2025-11-04T00:00:00"},"crossref":{"DOI":"10.1097/hep.0000000000001549","URL":"https://doi.org/10.1097/hep.0000000000001549","ISSN":["0270-9139","1527-3350"],"link":[{"URL":"https://journals.lww.com/10.1097/HEP.0000000000001549","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["AASLD/IDSA Practice Guideline on treatment of chronic hepatitis B"],"author":[{"given":"Marc G.","family":"Ghany","sequence":"first","affiliation":[{"name":"Clinical Hepatology Research Section, Liver Diseases Branch, National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, Bethesda, MD, USA"}]},{"given":"Calvin Q.","family":"Pan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NYU Langone Health, New York University Grossman School of Medicine, New York, NY, USA"}]},{"given":"Anna S.","family":"Lok","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA"}]},{"given":"Jordan J.","family":"Feld","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease, University Health Network, Canada"}]},{"given":"Joseph K.","family":"Lim","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases and Yale Liver Center, Yale University School of Medicine, New Haven, CT, USA"}]},{"given":"Su H.","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Asian Health at Cooperman Barnabas Medical Center, Florham Park, NJ, USA"},{"name":"Rutgers New Jersey Medical School, Newark, NJ, USA"},{"name":"Rutgers Institute for Health, Health Care Policy and Aging Research (IFH), New Brunswick, NJ, USA"}]},{"given":"Arthur Y.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA"},{"name":"Department of Medicine, Harvard Medical School, Boston, MA, USA"}]},{"given":"Amy S.","family":"Tang","sequence":"additional","affiliation":[{"name":"North East Medical Services, San Francisco, CA, USA"}]},{"given":"Mindie H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA"},{"name":"Department of Epidemiology and Population Health, Stanford University Medical Center, Palo Alto, CA, USA"},{"name":"Stanford Cancer Institute, Stanford University Medical Center, Palo Alto, CA, USA"}]},{"given":"Susanna","family":"Naggie","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC, USA"}]},{"given":"Mark S.","family":"Sulkowski","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}]},{"given":"Norberto","family":"Rodriguez-Baez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, University of Texas Southwestern Medical Center, Dallas, TX, USA"}]},{"given":"J.","family":"Chen","sequence":"additional","affiliation":[{"name":"Taiwan Hepatitis Information & Care Association (THICA), Princeton, NJ, USA"},{"name":"Rutgers Health, Robert Wood Johnson Medical School, Piscataway, NJ, USA"}]},{"given":"M. Hassan","family":"Murad","sequence":"additional","affiliation":[{"name":"Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, MN, USA"},{"name":"Preventive Medicine, Mayo Clinic, Rochester, MN, USA"}]},{"given":"Khaled S.","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Preventive Medicine, Mayo Clinic, Rochester, MN, USA"},{"name":"Division of Community Pediatric and Adolescent Medicine, Mayo Clinic Children’s, Rochester, MN, USA"}]},{"given":"Norah A.","family":"Terrault","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, CA, USA"}]}],"issued":{"date-parts":[[2025,11,4]]},"member":"276","prefix":"10.1097","source":"Crossref","volume":null,"created":{"date-time":"2025-11-04T14:01:43Z","timestamp":1762264903000,"date-parts":[[2025,11,4]]},"indexed":{"date-time":"2025-12-05T12:31:44Z","timestamp":1764937904812,"date-parts":[[2025,12,5]]},"subject":[],"abstract":"$33","language":"en","relation":{},"resource":{"primary":{"URL":"https://journals.lww.com/10.1097/HEP.0000000000001549"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","value":"2025-09-19"},{"name":"accepted","group":{"name":"publication_history","label":"Publication 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B","updated":"2025-11-05T07:14:19+00:00","published_date":"2025-11-04","best_oa_location":null}},"created_at":"2025-12-04T03:42:26.941Z","updated_at":"2025-12-08T12:24:58.509Z","tags":[{"paper_doi":"10.1097/hep.0000000000001549","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001549","tag_type":"condition","value":"Chronic Hepatitis B","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001549","tag_type":"study_design","value":"Practice Guideline","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001549","tag_type":"warning","value":"Design classified as a Practice Guideline rather than a primary study.","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001549","tag_type":"warning","value":"The abstract does not detail specific recommendations or effect estimates; full text review is needed for actionable specifics.","value_numeric":null}],"summaries":{"what_studied":"An evidence-based guideline for chronic hepatitis B using the GRADE approach, organized around six PICO questions on prevention (maternal-to-infant and horizontal transmission), liver cancer surveillance among HBsAg-positive persons with HCV/HDV/HIV co-infection and after HBsAg loss, and treatment in immune-tolerant or indeterminate phases plus antiviral therapy withdrawal.","limitations":"The abstract provides no specific recommendations or quantitative outcomes; scope is limited to six predefined PICO topics.","practice_takeaway":"Consult this updated guideline for evidence-based recommendations on preventing HBV transmission, HCC surveillance in specified HBsAg-positive populations, and decisions about treating immune-tolerant/indeterminate phases and stopping antivirals."}},{"doi":"10.3350/cmh.2025.0379","pmid":"40228807","title":"Correspondence to editorial on “Switching to besifovir in patients with chronic hepatitis B receiving tenofovir disoproxil fumarate: A randomized 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B","Tenofovir","Treatment"],"pubmed_id":"40228807","conclusions":"","publication_date":"2025-04-15T00:00:00"},"crossref":{"DOI":"10.3350/cmh.2025.0379","URL":"https://doi.org/10.3350/cmh.2025.0379","ISSN":["2287-2728","2287-285X"],"link":[{"URL":"http://e-cmh.org/upload/pdf/cmh-2025-0379.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http://e-cmh.org/journal/view.php?doi=10.3350/cmh.2025.0379","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http://e-cmh.org/upload/pdf/cmh-2025-0379.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"e55-e57","type":"journal-article","issue":"1","score":1,"title":["Correspondence to editorial on “Switching to besifovir in patients with chronic hepatitis B receiving tenofovir disoproxil fumarate: A randomized trial”"],"author":[{"given":"Hyung 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Hepatitis B","value_numeric":null},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"generic","value":"besifovir","value_numeric":null},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"generic","value":"tenofovir disoproxil fumarate","value_numeric":null},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"modality","value":"Nucleos(t)ide Analog","value_numeric":null},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"sample_size","value":"n=139","value_numeric":139},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"warning","value":"Bone and renal safety are referenced without numeric outcomes in this summary.","value_numeric":null},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"warning","value":"Study design label reflects the underlying randomized trial, not the correspondence article itself.","value_numeric":null},{"paper_doi":"10.3350/cmh.2025.0379","tag_type":"warning","value":"This is a correspondence summarizing an RCT; full trial methods and detailed safety data are not provided here.","value_numeric":null}],"summaries":{"what_studied":"A correspondence summarizes modified intention-to-treat (full analysis set) results from a randomized trial in chronic hepatitis B patients on long-term tenofovir disoproxil fumarate (TDF), comparing switching to besifovir (BSV) versus continuing TDF over 48 weeks (n=139).","key_result":"At week 48, virologic response was 100% (69/69) with BSV vs 98.6% (69/70) with TDF (P=1.00); alanine aminotransferase normalization was 89.9% (62/69) vs 85.7% (60/70) (P=0.456), HBeAg seroconversion 14.3% (4/28) vs 10.7% (3/28) (P=1.000), and HBsAg seroconversion 1 vs 0 (P=0.43). The authors also report improved bone and renal safety (by bone mineral density and eGFR) with BSV, with no numeric data provided here.","limitations":"This is a correspondence summary without numeric safety details; seven per group were excluded for criteria violations or other reasons and the mITT full analysis set included low-compliance patients; no head-to-head data versus TAF in TDF-experienced patients are provided.","practice_takeaway":"In TDF-experienced chronic hepatitis B, switching to besifovir maintained virologic control at 48 weeks and may offer bone and renal safety advantages. This supports considering BSV for patients on TDF with bone or kidney risk concerns."}}],"initialOffset":15,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Chronic Hepatitis B"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Chronic Hepatitis B"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Chronic Hepatitis B"}}}]]

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