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Review
. 2025 Oct;31(4):1197-1212.
doi: 10.3350/cmh.2025.0492. Epub 2025 Jul 28.

Global strategies and actions to eliminate hepatitis B virus infection

Chih-Lin Lin  1   2 , Jia-Horng Kao  3   4   5   6
Affiliations
Review

Global strategies and actions to eliminate hepatitis B virus infection

Chih-Lin Lin et al. Clin Mol Hepatol. 2025 Oct.

Abstract

Through the implementation of hepatitis B vaccination and effective antiviral treatment over the past four decades, the hepatitis B surface antigen (HBsAg) seroprevalence of the vaccinated generation dramatically decline. The incidence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) also decreases. However, the elimination of HBV is still a challenge to achieve. Novel HBV biomarkers, including quantitative HBsAg, hepatitis B virus core-related antigen and HBV RNA are promising in predicting clinical phases, risks of disease progression and HBV functional cure. Current antiviral therapies, nucleoside/nucleotide and pegylated alpha-interferon, effectively decrease HCC incidence in chronic hepatitis B (CHB) patients and minimize the recurrence of HCC in patients receiving curative therapy. Novel agents under development to achieve HBV cure include direct-acting antivirals that target various stages of the HBV lifecycle and host targeting agents that enhance HBV-specific immunity. The action plans for eliminating hepatitis B in the future are universal HBV screening, early and simplified treatment as well as precision lifelong management for CHB patients. This narrative review will summarize and discuss global strategies and initiatives aimed at eliminating HBV infection.

Keywords: Chronic hepatitis B; Functional cure; Hepatitis B virus; Hepatocellular carcinoma.

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Conflict of interest statement

Conflicts of Interest

The authors have no conflicts to disclose.

Figures

Figure 1.
Figure 1.
The proposed algorithm integrates both traditional and novel biomarkers for the personalized management of chronic hepatitis B. ALT, alanine aminotransferase; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCC, hepatocellular carcinoma. Modified from the article of Tseng et al.36 (Clin Liver Dis (Hoboken) 2024;23:e0155) with original copyright holder’s permission.
Figure 2.
Figure 2.
The modes of action of emerging antiviral agents targeting HBV. cccDNA, covalently closed circular DNA; HBcrAg, hepatitis B virus core-related antigen; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; NTCP, sodium taurocholate cotransporting polypeptide.
Figure 3.
Figure 3.
Two levels, 4 steps strategies and action plans to achieve the elimination of hepatitis B. HBsAg, hepatitis B surface antigen.
Figure 4.
Figure 4.
A lifetime HBV screening for adults aged 45 years and above in Taiwan since 2011. As of 2024, 6.12 million people have been screened for HBsAg. The average positive rate of HBsAg is 11%, demonstrating a declining trend year by year since 2015. HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus.
See this image and copyright information in PMC

References

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