Evidence map›Paper›PMID 41328917›Full record

ArticleThe Journal of infectious diseases2026

Oral Microbiome Diversity Matters on Nucleos(t)ide Analogue Cessation in Chronic Hepatitis B.

Mahin Ghorbani, Agne Kvedaraite, Khaled Al-Manei, Choon Boon Too, Susanne Cederberg, Asgeir Johannessen, Dag Henrik Reikvam, Davide Valentini, Christopher Maucourant, Niklas K Björkström and 2 more

Registry-linked trialAbstract read
In one paragraph

Article in The Journal of infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03681132 (The Norwegian Nucleoside Analogue Stop Study), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT03681132 phase4completednot on this map

The Norwegian Nucleoside Analogue Stop Study: a Randomized Open-label Trial in HBeAg Negative Chronic Hepatitis B, Aiming at Achieving a Functional Cure.

TypeinterventionalSponsorOslo University HospitalRan2018 to 2023Enrolled127ConditionsHepatitis B, ChronicArmsStop of therapy
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Mahin GhorbaniDivision of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden.ORCID 0009-0007-5028-3482
Agne KvedaraiteDivision of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden.ORCID 0009-0004-0881-5551
Khaled Al-ManeiDivision of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden.ORCID 0000-0003-0787-5849
Choon Boon TooDivision of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden.
Susanne CederbergDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
Asgeir JohannessenDepartment of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway.ORCID 0000-0001-5966-7166
Dag Henrik ReikvamDepartment of Infectious Diseases, Regional Advisory Unit for Imported and Tropical Diseases, Oslo University Hospital, Oslo, Norway.
Davide ValentiniDepartment of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0002-6771-7175
Christopher MaucourantCenter for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.
Niklas K BjörkströmCenter for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.ORCID 0000-0002-0967-076X
Soo AlemanDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
Margaret Sällberg ChenDivision of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden.ORCID 0000-0002-3793-4064

Funding

Authority 2018092Centre for Innovative MedicineRadiumhemmets ForskningsfonderRegion StockholmSouth-Eastern Norway Regional HealthSwedish Cancer Society
6 · The paper itself

Abstract

backgroundWithdrawal of nucleos(t)ide analogue (NUC) therapy in hepatitis B e antigen (HbeAg)-negative chronic hepatitis B (CHB) may lead to functional cure in a subset of patients. Although gut microbiota is known to influence both CHB progression and treatment outcomes, the oral microbiome in NUC cessation remains unexplored.

methodsThis longitudinal study explored the oral microbiome in patients with CHB on NUC therapy > 2 years having a planned NUC cessation. Oral microbiome composition was analyzed in 110 saliva samples across 7 time points from 18 HBeAg-negative patients with 36 months follow-up. Favorable outcome was defined as either HBsAg loss or decline of > 1 log10 or sustained off-therapy HBV DNA level < 2000 IU/mL during year 3. Hepatic flare was defined as alanine transaminase (ALT) > 80 U/L or 2 × baseline level.

resultsThe overall microbial composition remained stable during the study period. Patients with favorable outcome showed consistently higher alpha diversities (P < .001) from baseline, with lower intersample variations across all time points (P < .05), compared to unfavorable. Hepatitis B surface antigen (HBsAg), ALT, and aspartate transaminase (AST) correlated inversely with several Prevotella taxa and specific pathways (Spearman ρ > -0.5, P < .01). Unfavorable outcome and high HBsAg level correlated with opportunistic taxa Haemophilus parainfluenzae and Porphyromonas catoniae. Random forest model incorporating validated microbial markers predicting favorable versus unfavorable outcome achieved higher predictive performance than clinical markers alone (area under curve, 0.79 vs 0.66).

conclusionsOur exploratory study suggests that oral microbiome profiling at NUC cessation in HBeAg-negative CHB could support prognostication of virological outcome. Clinical Trials Registration. NCT03681132.

Indexed as

Antiviral AgentsHepatitis B, ChronicMicrobiotaMouthNucleosidesAdultAlanine TransaminaseDNA, ViralFemaleHepatitis B e AntigensHepatitis B Surface AntigensHepatitis B virusHumansLongitudinal StudiesMaleMiddle AgedAlanine TransaminaseAntiviral AgentsDNA, ViralHepatitis B e AntigensHepatitis B Surface AntigensNucleosidesantiviral treatmentcureHBVnucleos(t)ide analogue discontinuationoral microbiomeviral hepatitis

Identifiers

PMID41328917
PMCPMC13017730

What Socratic holds

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Registered trials

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.