Hepatitis B Surface Antigen Research Articles (Page 1)

Functional cure is a goal for the treatment of chronic hepatitis B virus (HBV) infection; however, it is infrequently achieved with currently approved treatments. Here we provide a randomized evaluation of the small interfering RNA elebsiran, in combination with pegylated interferon alfa (PEG-IFNα), compared with PEG-IFNα monotherapy. In addition, this study evaluates the potential role of the HBV therapeutic vaccine BRII-179 in identifying immunologically responsive patients and improving hepatitis B surface antigen (HBsAg) loss rates. In part I (cohorts 1-3), virally suppressed participants with chronic HBV infection naive to BRII-179 were randomized 1:1:1 to receive 48 weekly doses of PEG-IFNα alone or in combination with 13 doses of elebsiran (200 mg or 100 mg) administered every 4 weeks. In part II (cohort 4), participants who had previously received 9 doses of elebsiran and BRII-179 in a prospective study (BRII-179-835-001) were categorized as BRII-179 anti-HBs responders or nonresponders based on their peak hepatitis B surface antibody (anti-HBs) levels (≥10 IU l-1 or <10 IU l-1, respectively) and subsequently received 13 doses of elebsiran 100 mg every 4 weeks plus 48 weekly doses of PEG-IFNα. Primary endpoints were HBsAg loss at the end of treatment (EOT) and 24 weeks post-EOT. In part I, at 24 weeks post-EOT, HBsAg loss was observed in 4 out of 19 (21.1%) participants receiving elebsiran 200 mg plus PEG-IFNα, 6 out of 18 (33.3%) participants receiving elebsiran 100 mg plus PEG-IFNα and 1 out of 18 (5.6%) participants receiving PEG-IFNα monotherapy. In part II, HBsAg loss was observed in 9 out of 31 (29.0%) participants at 24 weeks post-EOT, with a higher response among BRII-179 anti-HBs responders (8 out of 19 participants, 42.1%) compared with nonresponders (1 out of 12 participants, 8.3%). Elebsiran and PEG-IFNα combination therapy was generally safe and well tolerated. These results demonstrate an additive benefit of elebsiran when combined with PEG-IFNα in achieving sustained HBsAg loss. Furthermore, the increased HBsAg loss rate in BRII-179 anti-HBs responders suggests that BRII-179 may be a valuable tool for immunological profiling to optimize curative outcomes in patients with HBV infection. ClinicalTrials.gov registration: NCT05970289 .

Owing to its high mortality rate, viral hepatitis is a major public health problem, especially in low-income countries. In Africa, hepatitis B virus (HBV) and hepatitis E virus (HEV) are highly endemic, and HBV/HEV coinfections, which are associated with more severe liver disease and poor outcomes, are common. HEV genotypes 1 and 2 have been associated with large human outbreaks, while 3 is known to circulate in pigs and sporadically in humans. In this study, the prevalence of HBV and HEV among individuals with acute or chronic liver diseases in Osun State, Southwest Nigeria, was analyzed. One hundred plasma samples from liver disease patients attending Ladoke Akintola University Teaching Hospital were analyzed for the presence of anti-HEV antibodies and hepatitis B surface antigen (HBsAg) via ELISA, and HEV RNA and HBV DNA were analyzed via RT‒PCR. Virus genotyping was performed by sequencing and subsequent phylogenetic analysis. Overall, 50 individuals (50%) were positive for HBsAg, of which 14 (28%) also tested positive for HBV DNA. Two individuals (2%) had occult HBV infection. Most HBV strains were genotype E, except for two genotype A (A2 and A3). Anti-HEV antibodies were detected in eight individuals (8%), with one (1%) being positive for anti-HEV IgM and seven (7%) for anti-HEV IgG. Nine (9%) samples had detectable HEV RNA, with one being HEV-3; a rare occurrence in Nigeria. Coinfection with HBV/HEV was detected in seven (7%) individuals. The prevalence of HEV in Nigeria is low, but considering the high prevalence of HBV and the possible complications due to HEV coinfection or superinfection, HEV screening and HBV vaccination targeting high-risk populations are emphasized.

Peg-interferon (peg-IFN) plays an increasingly important role in HBV cure strategies, either in combination with novel antivirals, as a lead-in or as consolidation treatment. We aimed to provide estimates of hepatitis B surface antigen (HBsAg) decline and clearance that can be achieved with peg-IFN addition to nucleos(t)ide analogue (NA) therapy. This is a post hoc meta-analysis of individual participant data from eight clinical trials involving chronic hepatitis B patients on NA therapy who received peg-IFN add-on. The primary endpoint was HBsAg loss at end of follow-up (EOF, 6-12 months after end of peg-IFN). Secondary analyses focused on HBsAg decline. 581 patients were included. At the start of peg-IFN therapy (SOT), 44% were hepatitis B envelope antigen (HBeAg) positive, mean HBsAg level was 3.03 log10 IU/mL (HBsAg<100: 12%; 100-1000: 28%; ≥1000: 60%), and planned duration of peg-IFN was 48 weeks in 496 patients (85%).At EOF, 50 (8.6%) patients achieved HBsAg loss (HBsAg<100/100-1000/≥1000: 37.7/9.8/2.3%, p<0.001) Findings were consistent across ethnicities (Caucasian: 30.0/8.7/3.6%; Asian: 39.3/9.2/2.2%). In patients with SOT HBsAg≥1000 IU/mL, levels <1000 and <100 were achieved in 29.7% and 8.9% at 24 weeks and in 47.5% and 16.3% at 48 weeks of peg-IFN therapy, respectively. Peg-IFN add-on results in HBsAg loss in 18% of patients with SOT HBsAg<1000 IU/mL, and in 38% if SOT HBsAg<100 IU/mL. Among patients with higher HBsAg levels, peg-IFN could be used to reduce HBsAg to below thresholds associated with response to novel compounds.

Globally, an estimated 296 million individuals live with chronic hepatitis B virus (HBV) infection, carrying substantial risks of liver fibrosis, cirrhosis and hepatocellular carcinoma. Fewer than 20% of patients receiving nucleos(t)ide analogues or interferons achieve a functional cure, underscoring the urgent need for novel therapeutic strategies to improve clinical outcomes in patients with chronic HBV infection. The aim of this study was to develop a 'virus-hunter vaccine' that hijacks HBV antigens as endogenous immunogens, reprogramming dendritic cells (DCs) to prime anti-HBV immunity, ultimately achieving a durable functional cure beyond current therapeutic limitations. We engineered the SHARP (Specific HBV Antigen-capturing and Rendering Promotor) vaccine platform, comprising a bispecific antibody targeting hepatitis B surface antigen (HBsAg) and DEC-205, conjugated with toll-like receptor 7/8 agonists. Therapeutic efficacy was assessed in chronic HBV carrier mice, with comprehensive investigation of immunological mechanisms. Both SHARP variants demonstrated enhanced antigen phagocytosis, maturation and antigen presentation of DCs. Notably, SHARP-D265A (DA) emerged as the lead candidate due to its optimised Fc silencing, showing superior therapeutic efficacy with a lower anti-drug antibody incidence. SHARP treatment reversed the tolerogenic microenvironment through coordinated activation of HBV-specific CD4+ and CD8+ T cells and established durable viral control: HBsAg was below the limit of detection, accompanied by the appearance of anti-HBsAg, which was maintained for more than 161 days with established immune memory against rechallenge. This innovative HBV vaccine strategy actively captures viruses, overcoming the tolerogenic immune microenvironment of chronic HBV infection, offering a novel strategy for the treatment of chronic HBV infection and other immune-tolerant diseases.

In the hepatitis B e antigen positive (HBeAg+) chronic infection disease phase, approved treatments have limited effects on hepatitis B surface antigen (HBsAg) and HBeAg. The phase 2 REEF-IT study (NCT04439539) assessed safety, efficacy and pharmacokinetics of pegylated interferon-α2a (PegIFN-α2a) add-on to JNJ-73763989 (JNJ-3989)±bersacapavir+nucleos(t)ide analogues (NA) in not currently treated, HBeAg+chronic hepatitis B. Participants received JNJ-3989 (200 mg every 4 weeks)+NA±bersacapavir (250 mg daily) for 36-52 weeks (induction) followed by 12 weeks of PegIFN-α2a (180 µg weekly) add-on. The primary endpoint was the proportion of participants with HBsAg seroclearance 24 weeks after stopping all treatment including NA. Changes in viral markers, safety and pharmacokinetics were assessed. 49/54 (91%) enrolled participants completed the study; 52% were male, with mean age of 33.6 years. No participant achieved the primary endpoint; one met NA completion criteria. 11/54 (20.4%) participants achieved HBsAg seroclearance at least once, 6 of them maintained it until Follow-up Week 48 (FUW48). Overall mean (SE) change from baseline in HBsAg of -2.85 (0.13), -3.61 (0.18) and -2.63 (0.26)log10IU/mL were observed at end of induction, end of treatment and FUW48. 16/53 (30.2%) participants reached HBeAg seroclearance at least once; 12 maintained it until FUW48. Similar proportions of participants experienced an adverse event (AE) during induction (83.3%), PegIFN-α2a add-on (85.7%) and follow-up (64.7%). There were no deaths or serious AEs; two participants discontinued PegIFN-α2a. In this population, adding PegIFN-α2a increased HBsAg declines after reductions by JNJ-3989; 20.4% achieved HBsAg seroclearance at least once. Treatment was generally safe with acceptable tolerability. NCT04439539.

BackgroundHepatitis B virus (HBV) infection is a major global health issue. Ethiopia is among the high endemic areas, with prevalence of infection more than 8%. However, data regarding factors associated with its acquisition in the study area is scarce. Therefore, this study aimed to explain factors associated with acquisition of HBV.MethodsA hospital-based unmatched case–control study was conducted in two government hospitals in Northeast Ethiopia, both of which serve as treatment centers for hepatitis. The source population included adult patients visiting the gastroenterology outpatient departments of these hospitals. A total of 288 participants were selected consecutively from June to December 2023. Data were collected using a structured questionnaire from cases; those with hepatitis B virus infection, or hepatitis B surface antigen (HBsAg) positive and controls; those who did not have hepatitis B infection, or HBsAg negative. Data analysis was performed by STATA version 17 for description statistics, bivariate and multivariable logistic regression to evaluate predictable variables for possible risk of HBV infection.ResultsA total of 288 participants (96 cases and 192 controls) were included. The median age of participants was 30 years. The proportion of females was higher among cases than controls (71.8% vs. 52.0%). A higher proportion of cases had multiple lifetime sexual partners (36.5% vs. 26%), a family history of hepatitis (40.6% vs. 20.3%), and a history of tattoos or ear piercing (74% vs. 36%). Multivariable analysis identified multiple sexual partners (AOR = 2.07; 95%CI: 1.07-4.00), traditional practices; tattooing, ear piercing, tonsillectomy; (AOR = 6.43; 95%CI: 3.12–13.23), and family history of hepatitis (AOR = 2.83; 95% CI: 1.48–5.42) as significant risk factors. Regarding age, higher proportion of infection is at age below35 years and a downward trend was noted as age increases. Among the cases, the proportion of females is higher than that of males (71.8 vs. 22.7%; P = 0.001).ConclusionMultiple sexual partners, family history of hepatitis, and traditional practices such as tattooing, ear piercing, and sharing sharps were strongly associated with HBV infection. Public health efforts should specifically target these individuals to address the identified risk factors and halt transmission dynamics. The greater number of cases below 35 years, and females with a decreasing tendency with age may be due to early disease progression and reduced survival rates among older individuals and males. This emphasizes there should be an expansion of early screening, especially for at-risk populations, to limit the progression of HBV.Clinical trial numberNot applicable.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12879-025-11970-8.

Astragaloside IV reduces hepatitis B surface antigen level via monocyte/macrophages in chronic HBV infection mice.

Introduction: The transfusion of blood and blood components are an essential therapeutic intervention and at present India’s blood requirement is about 9 to 9.5 million units per year. But blood banks in India are able to collect only about 5 to 5.5 million units per year. The causes of donor blood wastage are classified into shelf life expiry, seroreactivity, Quantity Not Sufficient (QNS), broken bags, lipaemic, dispensed but not transfused. Based on previous studies the discarding rate is ranging from 4.3 to 26.6%. Aim: To evaluate the causes of donor blood wastage in a tertiary care hospital. Materials and Methods: The present cross-sectional study included all the blood units received in the blood bank of Sri Venkateswara Ramnarayan Ruia Government General Hospital (SVRRGGH) for a period of six months (July 2024 to December 2024). Causes of discarded blood were analysed based on shelf life expiry, serological positivity and QNS. The results were analysed in the form of rates and percentages. Results: The total number of 3,761 blood units were collected during the study period, of which 347 (10.1%) units of whole blood and its components were discarded during the study period. Shelf life expiry 254 (73%) followed by seroreactivity 60 (17%) units were the two most common causes of discarding the blood and blood components. Conclusion: Regular screening for Human Immunodeficiency Virus (HIV) and Hepatitis B surface antigen (HBsAg) by rapid tests before bleeding decreases the wastage by deferring the donor. To arrange near expiry blood units in front shelves of refrigerator, regular audit of blood issue and discard by hospital transfusion committee to be done to minimise the wastage.

Prevalence of seropositive occult hepatitis B virus infection among patients received chemotherapy in Taiwan: A retrospective study.

Predictors of antiviral treatment in Chronic Hepatitis -B (CHB) population.

BackgroundThe correlation between hepatitis B virus (HBV) RNA, HBV DNA and hepatitis B surface antigen (HBsAg) during antiviral treatment and the clinical value of HBV RNA for virological response and drug discontinuance, are still unknown. This study was to investigate the clinical significance and predicting ability of HBV RNA for hepatitis B e antigen (HBeAg) seroconversion (SR) in chronic hepatitis B (CHB) patients receiving antiviral therapy.MethodsA total of 138 patients with CHB who were newly diagnosed from January 2023 to December 2023 were enrolled in this study. Patients were divided into the SR group and the non-seroconversion (NSR) group according to HBeAg SR in baseline to the 60th week. The dynamic changes and correlations between HBV RNA, HBV DNA, HBsAg and HBeAg was analyzed between the two groups and the predictive values of them for HBeAg SR were calculated.ResultsThe 60th week HBeAg SR rate was 23.9% (33/138), patients treated with tenofovir alafenamide fumarate (TAF) had higher SR rate than others (P < 0.001). After antiviral therapy, the serum HBV RNA levels of SR group decreased significantly than in the NSR group. Baseline HBV RNA levels were significantly correlated with HBV DNA, HBsAg and HBeAg in both groups, but weakened after antiviral therapy. Univariate and multivariate regression analysis showed that the serum HBV RNA levels at the 12th week was an independent predictor of HBeAg SR. The area under the receiver operating characteristic curve (AUROC) of the serum HBV RNA levels at the 12th week had a higher value (AUROC = 0.8039, 95% CI [0.691–0.917]). The cut off value of HBV RNA level with 5.68 lg copies/ml at the 12th week had a sensitivity of 76.47% and a specificity of 72.55% for predicting HBeAg SR.ConclusionsBaseline HBV RNA levels in CHB patients exhibited a significantly positive correlation with HBV DNA and HBsAg levels, this correlation weakened after antiviral therapy. The serum HBV RNA level at the 12th week could serve as an early predictor for the HBeAg SR in patients with CHB. The CHB patients treated with antiviral drug TAF showed a higher HBeAg SR rate compared to ETV and TDF.

Occult hepatitis B virus infection (OBI) represents a specific form of hepatitis B virus (HBV)infection characterized by the presence of replication-competent HBV DNA in the liver despite a negative blood test for hepatitis B surface antigen (HBsAg). Due to the incompletely-known mechanisms underlying its occurrence and the limitations of existing screening technologies, the viral loads in the blood of OBI patients are intermittent and often undetectable. Furthermore, lack of effective screening and shielding strategies in blood collection and supply institutions fail to prevent OBI individuals from donating blood, resulting in its susceptibility to transmission through blood transfusion, which poses a significant threat to blood safety. In this review, we summarize current understanding of OBI, challenges, and its implication in blood safety.

BackgroundPreventing mother-to-child transmission of hepatitis B (PMTCT) is crucial for reducing the incidence of new hepatitis B virus (HBV) infections. However, the current PMTCT interventions including maternal screening, antiviral prophylaxis, infant immunoprophylaxis, and post-vaccination serological testing, fail to reach a broader population, especially those in rural areas. This pilot study aimed to optimize the PMTCT strategy by integrating existing medical resources, with the goal of achieving high coverage of the complex intervention services.MethodsThis real-world pilot study was conducted from March 4, 2019, to May 27, 2020, in Zhangjiagang, a county under the jurisdiction of Suzhou, Jiangsu Province. We collaborated with multiple healthcare institutions to establish a comprehensive PMTCT strategy that combines decentralized and centralized service delivery. The intervention rate at each healthcare service related to PMTCT was the primary endpoint of the evaluation.ResultsA total of 11,181 pregnant women accepted HBV screening during their first antenatal care (ANC) visit. Among the 272 hepatitis B surface antigen (HBsAg) positive individuals, 64 (23.5%) were hepatitis B e antigen (HBeAg) positive. All 64 HBeAg-positive pregnant women (including one case of twin pregnancy) accepted the referral, of whom 53 met the criteria for antiviral prophylaxis, and 51 (96.2%) received the treatment. All 65 infants born to HBeAg-positive mothers completed post-vaccination serological testing (PVST) in designated institutions or others selected by their parents. The PVST results indicated complete success of the PMTCT strategy.ConclusionsBy integrating centralized and decentralized healthcare services through collaboration among multiple healthcare institutions, it is feasible to establish a whole-process service that provides pregnant women with more timely and comprehensive services. This strategy can improve the rate of antiviral prophylaxis for high-risk pregnant women with HBV MTCT, which is of great significance for eliminating MTCT of HBV.

BACKGROUNDExisting assessment systems for chronic hepatitis B (CHB)-associated liver fibrosis (LF) exhibit insufficient accuracy, thereby requiring further improvements.AIMTo investigate the association of LF staging with hepatitis B core antibody (HBcAb), hepatitis B virus DNA (HBV-DNA), and hepatitis B surface antigen (HBsAg) in patients with CHB.METHODSWe selected 120 patients with CHB receiving treatment in Hangzhou Linping District First People’s Hospital from January 2020 to June 2024. Participants were allocated into the mild (F0-F1, n = 52) and moderate-to-severe groups (F2-F4, n = 68) following the rigorous LF staging criteria. HBcAb, HBV-DNA, and HBsAg concentrations were measured. Pearson correlations were employed to examine the correlations of HBcAb with HBV-DNA and HBsAg, whereas Spearman correlation analysis was conducted to identify the associations of the three with LF staging. Receiver operating characteristic (ROC) curves were further used to analyze the performance of these biomarkers in diagnosing LF stages. Furthermore, binary logistic regression analysis was conducted to determine the association of these three with LF progression in CHB.RESULTSMarkedly increased HBcAb and notably decreased HBV-DNA and HBsAg were observed in moderate-to-severe cases vs their mild counterparts. A positive correlation was observed between HBV-DNA and HBsAg, whereas both markers were inversely associated with HBcAb. Moreover, LF staging exhibited a significant positive correlation with HBcAb and an inverse connection with HBV-DNA and HBsAg. The receiver operating characteristic analysis revealed area under the curve values of 0.715, 0.799, and 0.662 for HBcAb, HBV-DNA, and HBsAg in diagnosing LF staging, respectively. Combining these markers improved the area under the curve to 0.851. The final analysis identified HBcAb as promoting fibrosis advancement (odds ratio = 2.765), whereas HBV-DNA demonstrated protective properties (odds ratio = 0.247).CONCLUSIONHBcAb is negatively correlated with HBV-DNA and HBsAg but positively associated with LF staging. All three markers are valuable in assessing LF staging, and their combined use presents the highest diagnostic efficacy. Importantly, a high HBcAb/low HBV-DNA profile markedly increased fibrosis progression risks in CHB-affected individuals.

BACKGROUNDThe relationship between hepatitis B surface antigen (HBsAg) concentrations, hepatitis B virus (HBV) DNA levels, and hepatic function in individuals with chronic hepatitis B (CHB) remains incompletely characterized.AIMTo examine the association of serum HBsAg concentrations with HBV DNA levels and hepatic function parameters in patients with CHB.METHODSA total of 110 individuals with CHB admitted to Kunming Third People’s Hospital between January 2023 and January 2025 were enrolled as the observation group, whereas 70 age- and sex-matched healthy individuals served as the control group. Fasting peripheral venous blood (5 mL) was collected from all participants. Serum HBsAg and HBV DNA levels (in the observation group), along with hepatic function markers, including total bilirubin (TBIL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT), were measured in both groups. Pearson correlation analysis was used to assess the association between serum HBsAg levels and HBV DNA, TBIL, AST, and ALT levels in patients with CHB. Receiver operating characteristic (ROC) curve analysis was conducted to determine optimal cutoff values of HBsAg for predicting high viral load (HBV DNA ≥ 105 IU/mL) and significant liver injury (ALT ≥ 2 × upper limit of normal [ULN]).RESULTSHBsAg levels differed significantly across CHB phases: Immune tolerance (IT) phase (4.62 ± 1.51 lgIU/mL), immune clearance (IC) phase (3.84 ± 1.16 lgIU/mL), low replication (LR) phase (2.99 ± 0.66 lgIU/mL), and HBV e antigen-negative hepatitis (ENH) phase (3.40 ± 0.69 lgIU/mL). Corresponding HBV DNA levels were highest in the IT phase (7.41 ± 1.83 log copies/mL), followed by the IC phase (6.03 ± 1.92 log copies/mL), ENH phase (3.89 ± 1.23 log copies/mL), and LR phase (2.55 ± 1.00 log copies/mL). All hepatic function parameters in patients with CHB were significantly elevated compared to the healthy controls. Pearson correlation analysis showed significant positive associations between serum HBsAg levels and HBV DNA, TBIL, AST, and ALT levels. ROC analysis revealed that an HBsAg cutoff > 4.09 lgIU/mL predicted HBV DNA ≥ 105 IU/mL (high viral load) with 88.57% sensitivity, 78.67% specificity, and an area under the curve (AUC) of 0.868 (P < 0.001), while a cutoff > 4.07 lgIU/mL predicted ALT ≥ 2 × ULN (significant liver injury) with 69.70% sensitivity, 90.91% specificity, and an AUC of 0.821 (P < 0.001).CONCLUSIONSerum HBsAg, a noninvasive serological marker, holds significant clinical value in CHB management by aiding in the stratification of viral burden and the prediction of hepatic impairment.

BackgroundHigh levels of circulating hepatitis B surface antigen (HBsAg) contribute to the dysfunction of the host immune response against HBV and the persistence of viral infection. This study aimed to investigate the effects and mechanisms of Sophora alopecuroides biflavones glycoside (SABG), isolated from the traditional herbal medicine Sophora alopecuroides, on HBV replication and HBsAg secretion.MethodsTo systematically evaluate the antiviral efficacy, a comprehensive set of experimental analyses was employed, including qPCR, RT-qPCR, ELISA, Western blot and particle gel assay. The DIA-based proteomic analysis, CETSA, molecular docking, and molecular dynamics simulation analyses were combined to explore the potential mechanisms.ResultsWe discovered that SABG could not only remarkably inhibit intracellular level of HBV core DNA but also significantly reduce the extracellular levels of HBV DNA, pgRNA, HBsAg and e antigen (HBeAg). Intriguingly, SABG had no impact on the intracellular levels of HBV pgRNA and core protein; instead, it caused abnormal accumulation of S protein. Further mechanistic studies revealed that SABG could bind directly to the antigenic loop (AGL) domain of HBs, thereby obstructing its post-translational cellular vesicle-based transport process. Finally, we observed a synergistic effect of SABG and lamivudine in the inhibition of intracellular level of HBV core DNA and the extracellular level of HBsAg.ConclusionOur studies reveal that SABG exhibits an antiviral activity against HBV by directly binding to the antigenic loop of surface protein, thereby impeding its secretion, which provides pharmacological evidence for the potential use of SABG as a candidate for the alternative treatment of HBV infection.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12985-025-02970-w.

Background: Hepatitis B virus (HBV) is a major public health issue, leading to cirrhosis and hepatocellular carcinoma. Vertical transmission of HBV can be effectively prevented with timely immunoprophylaxis, post-vaccination follow-up, and serological testing. Objectives: The aim of this study is to assess real-life adherence to follow-up protocols for hepatitis B surface antigen (HBsAg)-positive mothers and their infants in our center. Methods: We retrospectively reviewed records of 137 HBsAg-positive mothers and 167 infants born between 2017 and 2022. Data on hepatitis B immunoglobulin (HBIG) and vaccine administration at birth, as well as rates and timing of postnatal serological testing (anti-HBs, HBsAg, anti-HBc IgG), were analyzed. Hepatitis B e antigen (HBeAg), HBV DNA results, and antiviral treatment data of the mothers during pregnancy follow-up were also analyzed. Results: All infants received the first dose of the hepatitis B vaccine at birth, and 163 infants (97.6%) received HBIG at birth. However, only 12.5% of infants underwent anti-HBs testing, and just 10.6% were tested at the recommended age. Among those tested appropriately, 70.5% achieved protective anti-HBs levels. It was determined that serologic follow-up was performed more frequently in infants of mothers who received antiviral treatment during pregnancy (P &lt; 0.001). Conclusions: While birth-dose immunoprophylaxis rates were high, post-vaccination serological follow-up was markedly insufficient. This discrepancy emphasizes the necessity of implementing uniform follow-up procedures, educating healthcare professionals, and raising awareness among families to ensure better adherence to established HBV management protocols.

Background/Aims: Patients with hepatitis B–related decompensated cirrhosis may achieve recompensation. The alanine aminotransferase (ALT) to quantitative hepatitis B surface antigen (qHBsAg) ratio is a novel predictor for hepatitis B surface antigen (HBsAg) seroclearance. This study evaluates its utility in predicting recompensation based on Baveno VII criteria. Materials and Methods: Decompensated hepatitis B–related cirrhosis patients were recruited and received antiviral treatment for at least 12 months. Classification of these participants into the decompensated and recompensated groups was established according to the Baveno VII criteria. Logistic regression and subgroup analysis assessed the correlation between the ratio of ALT to qHBsAg at baseline and cirrhotic recompensation. Results: A total of 136 patients were involved in this study; 80 (58.8%) patients achieved recompensation. Univariate analysis associated recompensation with sex, age, ALT, aspartate aminotransferase, hepatitis B virus DNA (HBV DNA), qHBsAg, and ALT/logqHBsAg. Multivariate analysis confirmed that higher ALT/logqHBsAg independently predicted greater recompensation likelihood (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 1.00~1.02; P = .027). Categorically, ALT/logqHBsAg &gt; 23.48 significantly increased recompensation probability (OR = 3.21, 95% CI = 1.31~7.90, P = .011). Subgroup analyses across 7 pre-specified subgroups (sex, age, hepatitis B e antigen, HBV DNA, Child–Pugh grade, Model for End-Stage Liver Disease score, qHBsAg) demonstrated consistent relationships. Enhanced predictive power was observed in Child–Pugh class C versus classes A/B and in males versus females. Conclusion: Elevated baseline ALT/logqHBsAg predicts a higher likelihood of hepatic recompensation in hepatitis B–related cirrhosis under Baveno VII criteria. Cite this article as: Xu Y, Zhang Y, Jiao S, Lin C, Ye Q, Wang Y. The correlation between the ratio of ALT to qHBsAg and the recompensation of HBV-related cirrhosis patients: A retrospective cohort study based on the Baveno VII criteria. Turk J Gastroenterol. 2025;36(11):787-795.

Background: Adverse effects begin to increase when the corticosteroid (CS) dose exceeds 10 - 15 mg/day of prednisolone equivalent. One such effect is the possible reactivation of infections like chronic hepatitis B (CHB). In countries where the prevalence of hepatitis B surface antigen (HBsAg) exceeds 2%, hepatitis B virus (HBV) screening should be performed before starting immunosuppressive therapy. Objectives: This study evaluated CS use rates in inpatients and HBV screening data in these patients. Methods: This multicenter study used a point-prevalence design. On January 28, 2023, all inpatients at the included centers were evaluated for current treatment, and patients receiving CS were identified. Medical records and hospital databases were searched for HBV serologic tests in these patients. Results: A total of 6818 inpatients from 22 centers were evaluated, and the rate of CS use was 10.6%. Clinics with the highest CS use were pulmonary diseases (47.6%) and rheumatology (40.6%). The most common indications were respiratory system diseases (57.8%) and malignancy (6.2%). It was determined that only 22.6% of all patients receiving CS underwent adequate screening for HBV. Examination of CS use revealed 6 cases (3.7%) with high risk, 8 cases (4.9%) with moderate risk, and 35 cases (21.3%) with low risk of CHB reactivation. Fifty-seven patients (34.8%) with adequate screening were consulted to the infectious disease clinic for the risk of CHB reactivation. Of these, 9 (15.8%) were started on CHB prophylaxis. Conclusions: Our study found that, despite the high rate of CS use of 10.6%, only 22.6% of CS users had adequate screening for CHB prophylaxis. Despite Turkey's endemic status, the limited attention paid to this issue by healthcare professionals is worrying.

Chronic Hepatitis B (CHB) is a global health concern, affecting hundreds of millions and potentially leading to severe outcomes, such as cirrhosis and hepatocellular carcinoma. The primary treatment goal is to achieve a functional cure-defined as the loss of hepatitis B surface antigen (HBsAg) 24weeks after the cessation of therapy-which reduces liver inflammation, improves histopathology, and decreases the incidence of end-stage liver disease. However, this goal is rarely achieved with current therapies, especially monotherapies. With a deeper understanding of the HBV lifecycle and its interactions with the host immune system, combination therapy strategies are increasingly demonstrating potential to enhance treatment outcomes for CHB. This article reviews the application of novel drugs in combination therapy, analyzes the suitability of different drug combinations, and evaluates their effects on HBsAg clearance rates and overall cure rates. The review identified several promising drugs, such as capsid assembly modulators, entry inhibitors, and RNA interference therapies, which demonstrated greater efficacy in combination therapy, achieving higher HBsAg clearance and enhanced immune responses compared to monotherapies. However, effectiveness varied among patient subgroups, highlighting the need for personalized treatment. Combination therapies involving novel drugs hold promise for improving CHB outcomes, particularly in achieving a functional cure. Further research is required to optimize personalized regimens and to assess their long-term safety and efficacy for broader clinical use.