Manrai M, Jha AA, Pachisia AV, Dawra S. Chronic hepatitis B: Is it time for expanded antiviral treatment? World J Virol 2025; 14(3): 103347 [DOI: 10.5501/wjv.v14.i3.103347]
Corresponding Author of This Article
Manish Manrai, Professor, Department of Gastroenterology, Command Hospital, Lucknow Cantt, Lucknow 226002, Uttar Pradesh, India. manishmanrai75@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Virol. Sep 25, 2025; 14(3): 103347 Published online Sep 25, 2025. doi: 10.5501/wjv.v14.i3.103347
Chronic hepatitis B: Is it time for expanded antiviral treatment?
Manish Manrai, Atul A Jha, Aditya V Pachisia, Saurabh Dawra
Manish Manrai, Atul A Jha, Department of Gastroenterology, Command Hospital, Lucknow 226002, Uttar Pradesh, India
Aditya V Pachisia, Department of Gastroenterology, Command Hospital, Bangalore 560007, Karnataka, India
Saurabh Dawra, Department of Gastroenterology, Command Hospital, Udhampur 182101, Jammu and Kashmīr, India
Author contributions: Manrai M conceptualized, supervised the review study, and was involved with resources, editing, and validation; Jha AA was involved with resources and writing; Pachisia AV was involved in resources, writing, and editing; Dawra S was involved with resources and writing.
Conflict-of-interest statement: There is no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Manish Manrai, Professor, Department of Gastroenterology, Command Hospital, Lucknow Cantt, Lucknow 226002, Uttar Pradesh, India. manishmanrai75@gmail.com
Received: November 18, 2024 Revised: May 1, 2025 Accepted: July 11, 2025 Published online: September 25, 2025 Processing time: 313 Days and 14.7 Hours
Abstract
An estimated 3%-4% of people are living with the hepatitis B virus (HBV), and without treatment, the risk of developing cirrhosis and hepatocellular cancer (HCC) is an omnipresent threat. Prevention of HCC is a major challenge, as the association between viral suppression and HCC risk reduction is multifactorial, involving the progressive depletion of hepatocytes through covalently closed circular DNA integration, as well as the prevention of liver fibrosis and cirrhosis. Despite effective and cheap antiviral treatment capable of suppressing HBV replication and thereby cirrhosis and HCC, the current indications for therapy need revision and more research to expand the gamut and treat more infected people. In this review, we discuss the possible expansion of antiviral treatment in chronic hepatitis B to prevent cirrhosis and, importantly, HCC.
Core Tip: An estimated 254 million people, almost 3.3% of the world's population, are estimated to be living with chronic hepatitis B infection. Without therapy, they are at risk of developing cirrhosis and may develop hepatocellular cancer. The prevention of hepatocellular carcinoma is a major challenge. We review the various clinical practice guidelines and consider emerging evidence that will foster research to consider the expansion of treatment indications of chronic hepatitis B.
