Evidence mapPaperPMID 40714040Full record

ReviewThe lancet. Gastroenterology & hepatology2025

Scientific and medical evidence informing expansion of hepatitis B treatment guidelines.

Patrick T Kennedy, Lena Allweiss, Antonio Bertoletti, Markus Cornberg, Adam J Gehring, Luca G Guidotti, Hélène A Kerth, Maud Lemoine, Massimo Levrero, Seng Gee Lim and 4 more

Abstract readReview
In one paragraph

Review in The lancet. Gastroenterology & hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. [APASL clinical practice guidelines on the management of chronic hepatitis B infection: a 2026 update].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Article
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Patrick T KennedyImmunobiology, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. Electronic address: p.kennedy@qmul.ac.uk.
Lena AllweissMedical Clinic and Polyclinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research, Hamburg-Lübeck-Borstel-Riems Site, Hamburg, Germany.
Antonio BertolettiProgramme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore.
Markus CornbergDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany; German Center for Infection Research, Partner Site Hannover-Braunschweig, Hannover, Germany; Centre for Individualised Infection Medicine, Hannover, Germany; Cluster of Excellence RESIST, Hannover, Germany.
Adam J GehringSchwartz Reisman Liver Research Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Toronto Centre for Liver Disease, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Department of Immunology, University of Toronto, Toronto, ON, Canada.
Luca G GuidottiDivision of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Hélène A KerthInstitute of Virology, Technical University of Munich/Helmholtz Center Munich, Munich, Germany; German Center for Infectious Research, Munich Partner Site, Munich, Germany.
Maud LemoineDepartment of Metabolism Digestion and Reproduction-Liver Unit, St Mary's Hospital, London, UK.
Massimo LevreroINSERM U1052, CNRS UMR-5286, Cancer Research Center of Lyon, Lyon, France; University of Lyon, UMR_S1052, Cancer Research Center of Lyon, Lyon, France; The Lyon Hepatology Institute EVEREST, Lyon, France; Department of Hepatology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Department of Internal Medicine, Sapienza University, Rome, Italy; IIT Center for Life Nanoscience, Sapienza University, Rome, Italy.
Seng Gee LimDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore.
John E TavisDepartment of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA; Institute for Drug and Biotherapeutic Development, Saint Louis University, Saint Louis, MO, USA.
Barbara TestoniUniversité Claude-Bernard Lyon 1, INSERM, UMR 1350 PaThLiv, Lyon, France; The Lyon Hepatology Institute, IHU EVEREST, Lyon, France.
Thomas TuWestmead Institute for Medical Research, University of Sydney School of Medicine and Health, Sydney, NSW, Australia.
International Coalition to Eliminate HBV

Funding

Lead optimization of Hepatitis B Virus ribonuclease H inhibitorsR01AI150610 · NIAID · SAINT LOUIS UNIVERSITY · 2022 to 2025
$2.6M
HBV RNaseH inhibitors: Effects on HBV biology and resistance developmentR01AI148362 · NIAID · SAINT LOUIS UNIVERSITY · PI JOHN E TAVIS · 2021 to 2024
$1.5M
NIAID NIH HHS R01 AI148362NIAID NIH HHS R01 AI150610
6 · The paper itself

Abstract

Chronic hepatitis B treatment relies on nucleoside or nucleotide analogue drugs that suppress hepatitis B virus (HBV) replication, normalise liver enzymes, and slow disease progression with excellent safety profiles. Treatment is not curative, and patients remain at risk of cirrhosis and hepatocellular carcinoma. Treatment guidelines have generally restricted antiviral therapy to individuals with high HBV DNA and elevated ALT or hepatic fibrosis, often requiring longitudinal testing that can be scarcely available in resource-limited settings. Consequently, fewer than 3% of people living with HBV infection are receiving antiviral therapy. Guidelines from China and WHO recently broadened access criteria to antiviral therapy, but there are people who fall outside these guidelines who could still benefit from treatment initiation. The pathological processes induced by HBV infection are still active in these patients. We present the benefits and risks of expanding treatment eligibility. We believe that the benefits of reduced hepatic damage and carcinogenic stimuli greatly outweigh the risks.

Indexed as

Antiviral AgentsHepatitis B, ChronicPractice Guidelines as TopicCarcinoma, HepatocellularDNA, ViralHepatitis B virusHumansLiver CirrhosisLiver NeoplasmsAntiviral AgentsDNA, Viral

Identifiers

PMID40714040
PMCPMC12797741

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.