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Review
. 2025 Jun 3:389:e079579.
doi: 10.1136/bmj-2024-079579.

Advances in the management of hepatitis B

Affiliations
Review

Advances in the management of hepatitis B

Ruma Rajbhandari et al. BMJ. .

Abstract

Hepatitis B virus infection remains a pervasive global health challenge, affecting an estimated 254 million people worldwide. This review summarizes the current landscape of hepatitis B, including its epidemiology and the clinical spectrum of acute and chronic infection. It discusses the interplay between host and virus that underlies the progression from acute hepatitis to chronic liver disease, cirrhosis, and hepatocellular carcinoma. The review further examines current screening practices, diagnostic methods, and staging tools, as well as providing an in-depth evaluation of antiviral treatment strategies guided by randomized clinical trials and international consensus. Particular emphasis is placed on emerging therapeutic approaches. Drawing on high quality evidence from large scale epidemiological studies, rigorous clinical trials, and evolving global guidelines, this review not only encapsulates the state of the art in the management of hepatitis B but also highlights critical gaps and future directions. This synthesis is intended to inform clinicians and researchers alike, offering insights that may enhance patient care and guide future research toward the ultimate goal of elimination of hepatitis B.

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Conflict of interest statement

Competing interests: We have read and understood the BMJ policy on declaration of interests and declare the following interests within the past 36 months: research grant support from Abbvie, Janssen, Boehringer, BMS, and GSK to RC’s institution; RC has served on scientific advisory boards for GSK and Precision Biosciences.

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