Zou LF, Yu SD, Luo Y, Wang CL. Biological interpretation of baseline hepatitis B surface antigen and cirrhosis in determining interferon treatment duration. World J Gastroenterol 2026; 32(38): 119697 [DOI: 10.3748/wjg.119697]
Corresponding Author of This Article
Cheng-Long Wang, MD, PhD, Department of Pathology, Chongqing Traditional Chinese Medicine Hospital, No. 6 Panxi 7 Branch Road, Liangjiang New Area, Chongqing 400021, China. qq171909771@gmail.com
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Gastroenterology & Hepatology
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review-article
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Zou LF, Yu SD, Luo Y, Wang CL. Biological interpretation of baseline hepatitis B surface antigen and cirrhosis in determining interferon treatment duration. World J Gastroenterol 2026; 32(38): 119697 [DOI: 10.3748/wjg.119697]
World J Gastroenterol. Oct 14, 2026; 32(38): 119697 Published online Oct 14, 2026. doi: 10.3748/wjg.119697
Biological interpretation of baseline hepatitis B surface antigen and cirrhosis in determining interferon treatment duration
Ling-Feng Zou, Shao-Ding Yu, Yan Luo, Cheng-Long Wang
Ling-Feng Zou, Cheng-Long Wang, Department of Pathology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China
Shao-Ding Yu, Department of Orthopaedics, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China
Yan Luo, Department of Stomatology, The People’s Hospital of Dadukou District, Chongqing 400084, China
Co-first authors: Ling-Feng Zou and Shao-Ding Yu.
Co-corresponding authors: Yan Luo and Cheng-Long Wang.
Author contributions: Zou LF and Yu SD contributed equally as co-first authors, developing the conceptual framework, reviewing the literature, and drafting and critically revising the manuscript. Zou LF and Wang CL designed the overall structure and scope of the manuscript and contributed to interpretation and discussion of the content; Yu SD and Luo Y assisted with literature review, writing, and editing; Luo Y and Wang CL contributed equally as co-corresponding authors, supervising the project, guiding manuscript preparation, and critically revising it for intellectual content. All authors read and approved the final manuscript.
AI contribution statement: ChatGPT was used only for preliminary language polishing to improve grammar, clarity, and readability.
Supported by the Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau), No. 2023MSXM060.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Cheng-Long Wang, MD, PhD, Department of Pathology, Chongqing Traditional Chinese Medicine Hospital, No. 6 Panxi 7 Branch Road, Liangjiang New Area, Chongqing 400021, China. qq171909771@gmail.com
Received: February 3, 2026 Revised: March 26, 2026 Accepted: April 13, 2026 Published online: October 14, 2026 Processing time: 215 Days and 22.7 Hours
Abstract
The recent identification of baseline hepatitis B surface antigen and cirrhosis as independent predictors of extended interferon therapy provides a valuable clinical framework, yet the biological mechanisms underlying these associations require further elucidation. In this opinion review, we interpret these factors not merely as statistical covariates but as pathological surrogates for the virus-host equilibrium. We propose that high baseline hepatitis B surface antigen may reflect a deeply entrenched intrahepatic viral reservoir and may create an antigen-rich environment that impairs effective antiviral immunity. Concurrently, cirrhosis may be better understood as a spectrum of architectural remodeling in which vascular changes and sinusoidal defenestration could limit immune surveillance and affect local therapeutic access. Consequently, treatment durations exceeding 48 weeks may be required, at least in part, to overcome these profound immunological and structural barriers. We advocate shifting future predictive modeling from binary clinical definitions to a granular integration of viral kinetics and histological morphology to refine precision medicine in chronic hepatitis B.
Core Tip: We interpret baseline hepatitis B surface antigen and cirrhosis as pathological surrogates for the virus-host equilibrium. High hepatitis B surface antigen may indicate an entrenched viral reservoir and may be associated with persistent antigenic pressure that contributes to antiviral immune dysfunction, while cirrhotic vascular remodeling may reduce the efficiency of immune surveillance. Consequently, extended interferon therapy may be more frequently required in patients with these biological and structural constraints.
