Huang XF, Zeng JQ. Letter to the Editor: Physical functioning as a neglected determinant of antiviral adherence in chronic hepatitis B. World J Virol 2026; 15(2): 117858 [DOI: 10.5501/wjv.v15.i2.117858]
Corresponding Author of This Article
Jing-Qi Zeng, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Yangguang South Street, Liangxiang Higher Education Park, Fangshan District, Beijing 102488, China. zjingqi@163.com
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Infectious Diseases
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letter
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Huang XF, Zeng JQ. Letter to the Editor: Physical functioning as a neglected determinant of antiviral adherence in chronic hepatitis B. World J Virol 2026; 15(2): 117858 [DOI: 10.5501/wjv.v15.i2.117858]
World J Virol. Jun 25, 2026; 15(2): 117858 Published online Jun 25, 2026. doi: 10.5501/wjv.v15.i2.117858
Letter to the Editor: Physical functioning as a neglected determinant of antiviral adherence in chronic hepatitis B
Xiao-Feng Huang, Jing-Qi Zeng
Xiao-Feng Huang, The Third Clinical Medical College, Xinjiang Medical University, Urumqi 830017, Xinjiang Uygur Autonomous Region, China
Jing-Qi Zeng, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 102488, China
Author contributions: Huang XF drafted the manuscript; Zeng JQ critically revised the manuscript and supervised the work; both authors approved the final version of the manuscript.
AI contribution statement: During the process of writing the manuscript, an AI-assisted language tool was used. This AI tool was only employed for language polishing, grammar correction, and improving the readability and expression effectiveness of the article. It was not used to generate original scientific content, data, references, or conclusions.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Jing-Qi Zeng, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Yangguang South Street, Liangxiang Higher Education Park, Fangshan District, Beijing 102488, China. zjingqi@163.com
Received: December 18, 2025 Revised: January 6, 2026 Accepted: January 26, 2026 Published online: June 25, 2026 Processing time: 182 Days and 24 Hours
Abstract
As global strategies shift toward expanding treatment eligibility for chronic hepatitis B, ensuring long-term adherence is critical. Block et al recently published a study in World Journal of Virology, challenging the conventional focus on economic barriers and revealing that compromised physical functioning is a significantly more potent predictor of non-adherence than financial affordability. This finding exposes a profound “clinical discordance”: Patients may achieve viral suppression yet suffer from residual fatigue and functional impairment, potentially driven by immune exhaustion or metabolic comorbidities. We argue that this symptom burden serves as a functional blockade to daily persistence. Therefore, clinical care must evolve from “adherence policing” to active symptom management. Integrating patient-reported outcomes and addressing physical deficits are essential strategies to safeguard the efficacy of antiviral regimens in the elimination era.
Core Tip: New evidence indicates that physical functioning plays a more important role than affordability in shaping medication adherence among people with chronic hepatitis B. Addressing residual fatigue and related symptoms may be critical for sustaining long-term antiviral therapy.
