SpecialtiesQuestion

How do you decide which patients should pursue add-on bepirovirsen rather than continue indefinite nucleos(t)ide analogue monotherapy for noncirrhotic chronic HBV?

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When ALT is persistently normal and HBV DNA is high but noninvasive markers suggest more advanced disease, how do you triage between biopsy, immediate antiviral therapy, or close observation—and which discordance patterns most strongly suggest “silent” progression in your experience?

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How do you decide on long-term nucleos(t)ide therapy vs intensified MASLD management/monitoring in an HBeAg-negative indeterminate-phase patient with mildly elevated/fluctuating ALT, low-level HBV DNA, and borderline VCTE stiffness (around 8 kPa) where MASLD may confound fibrosis assessment?

Does concern about immune reactivation and retreatment cycles after nucleos(t)ide analogue cessation change which patients you are willing to stop (or how you monitor them) in order to mitigate hepatocellular carcinoma risk?

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