Pathological Entity Research Articles

CIC-DUX4 Sarcoma Involving the Skull Base: A Rare Presentation and Review of the Literature.

Background CIC-DUX4 sarcoma is a rare, aggressive tumor that is difficult to diagnose. Although it is closely related to Ewing's sarcoma, each is a distinct pathologic entity and both have been previously reported in the skin, lymph nodes, and viscera. We report the first description of CIC-DUX4 involving the posterior cranial fossa and review the distinctive symptomatology, morphology, immunoprofile, and genetic signature that differentiate this rare tumor. Case Report A 32-year-old man presented with an enlarging right lateral neck mass, progressive hoarseness, and orofacial pain. Biopsy revealed a high-grade undifferentiated malignant neoplasm. Imaging demonstrated an 8-cm mass in the right neck extending to the skull base and abutting the carotid sheath, in addition to pulmonary nodules and pelvic lymphadenopathy. Despite initial response to chemotherapy, he experienced disease progression and underwent surgical resection, radical neck dissection, and brachytherapy. Definitive pathologic diagnosis was achieved with next-generation sequencing. Within weeks of treatment, he developed symptoms reflecting progression of disease involving the neck, posterior cranial fossa, and lung. Adjuvant chemotherapy was planned, but the patient succumbed to his disease prior to initiation of further therapy. Conclusion CIC-DUX4 sarcomas are uncommon and can progress rapidly. Diagnosis requires either fluorescence in situ hybridization or next-generation sequencing. Due to its rarity, there is no standard-of-care treatment for this tumor and further investigations are needed to understand disease behavior and develop targeted therapeutic modalities.

Terapia inmunomoduladora sistémica en el tratamiento de la dermatitis atópica: el valor de Tralokinumab

Atopic dermatitis is a chronic inflammatory skin disease that substantially impacts the quality of life and functional capacity of those who suffer from it. In the midst of describing the pathogenesis and pathophysiology of this condition, the aberrant activity of interleukins (ILs) stands out, mainly IL-13 type 2. Currently, there is no definitive and safe treatment to address this disease. Traditionally, antibiotic therapy and corticosteroids have been indicated, but given the adverse effects commonly reported with these drugs, it is not reproducible or safe to continue with these regimens. Over the last few years, some agents with immunomodulatory potential have been proposed, which could change the course of atopic dermatitis. Within the global health objectives stipulated for the year 2030, there is the need to develop drugs that allow control of the burden of diseases that generate pathological entities that considerably affect both the quality of life and the catastrophic expense of the global population. with main emphasis on low- and middle-income countries, where difficulties prevail for timely and effective access to health services and targeted treatments. Therefore, the effort to find an agent that regulates chronicity or solves this disease is a priority both for dermatology and for global health.

Correlation of pulp stones to hyperlipidemia and hypertension: a clinico pathological hospital-based study

Pulp stones signify the calcification of the discrete origin seen in the pulp tissues and are seen either embedded or attached to the dentin. Pulp stones can be a pathological or physiological entity. The pathogenesis of the pulp stone formation is idiopathic. However, various theories have been proposed. Pulp stone frequency is in the range of 8% to 90%. They are more identified on the histopathologic examination than radiographic assessment. The present study aimed to assess and correlate the histopathologic analysis and clinical parameters of the pulp stones to hyperlipidemia and systemic hypertension. The study assessed 140 subjects for the correlation of histopathologic analysis and clinical parameters of the pulp stones to hyperlipidemia and systemic hypertension. After inclusion, detailed case history was recorded for all the participants. This was followed by the radiographic assessment, and the pulp tissue after extirpation was sent for processing. The data gathered was statistically assessed with the Chi-square test and SPSS software. The study showed that on radiographic assessment, pulp stones were seen in 28 subjects and histopathologic assessment in 60 subjects among the total studied 140 subjects. Hyperlipidemia and hypertension were significantly associated with using nonlaminated and uneven varieties of pulp stone. The study concludes that subjects having irregularly shaped and nonlaminated pulp stones on histopathologic analysis should undergo assessment for systemic hypertension and hyperlipidemia.

Orthorexia nervosa versus healthy orthorexia: Anxiety, perfectionism, and mindfulness as risk and preventative factors of distress.

Orthorexia nervosa is a recently conceptualised pathological entity presenting as an obsessive focus on healthy eating with associated psychosocial impairment. The present study investigated the differential associations between orthorexia nervosa and healthy orthorexia with distress and impairment. With a community sample (N = 268) multiple measures of orthorexia nervosa and health orthorexia were compared as explanatory variables in mediation structural equation modelling (SEM). Outcome variables assessed and investigated were psychological distress while demographic variables were controlled. The mediating roles of perfectionism and health anxiety on orthorexia nervosa were examined with further preventative mediation role of mindfulness on distress. Distinctive to other eating disorders, gender showed no significant effects on orthorexia nervosa and healthy orthorexia. Signalling measurement issues for this disorder, the different measures of orthorexia nervosa resulted in mixed findings regarding body mass index and age. Findings supported perfectionism and health anxiety as risk factors, as well as mindfulness acceptance as a preventative factor in both orthorexia nervosa and healthy orthorexia. Orthorexia nervosa and healthy orthorexia assessed by most measures, contrary to the expectations, had significant positive associations with psychological distress indicated by stress, anxiety, and depression. The complexity in differentiating orthorexia nervosa from healthy orthorexia calls for further investigation. This research effort should serve to substantiate the status of orthorexia nervosa as a distinct clinical disorder.

Atypical Teratoid/Rhabdoid Tumor of the Nervous System in Adults: Location-Related Features and Outcome

Atypical teratoid/rhabdoid tumor (AT/RT) of the nervous system is a rare and highly malignant neoplasm, mainly affecting children, first recognized as a pathologic entity in 1996 and added to the World Health Organization Classification of the Tumors of the Central Nervous System in 2000. AT/RT is even rarer among adults and is associated with a worse prognosis. The aim of the present study was to analyze the different tumor features according to the location in adults. A comprehensive and detailed literature review of AT/RTs in adults was made. The demographic, management, and outcome data associated with tumor location were analyzed and compared; histopathologic and molecular features were also discussed. Furthermore, we added our personal case with brain hemispheric localization and reported a progression-free survival of 103 months after gross total resection and adjuvant radiotherapy showing a peculiar histopathologic pattern. Female sex is mainly affected by AT/RT on median localizations, both intracranial and spinal, and by all sellar region cases. Gross total resection is mainly achieved among lateral compared with median localizations. Combined radiotherapy and chemotherapy is the most adopted adjuvant treatment in all tumor localizations and is related to better outcome. Postoperative death is reported only among sellar region localizations, whereas brain hemispheric cases show the best overall survival. AT/RTs show different and peculiar features according to their location, which significantly affects the outcome; precise knowledge of them helps the neurosurgeon in planning the best strategy for treatment.

Association of chronic periodontitis with multiple sclerosis: A systematic review and meta-analysis.

Chronic periodontitis (CP) is a multifactorial, chronic inflammatory disease of microbial etiology that manifests as a result of the dysfunction of the immune mechanism, culminating in the destruction of the alveolar bone of the jaws. Multiple sclerosis (MS) is an autoimmune disorder that affects the central nervous system (CNS), leads to demyelination and degeneration of nerve axons and often causes severe physical and/or cognitive impairment. As CP and MS involve inflammatory mechanisms and immune dysfunction, researchers have attempted to study the association between them. To systematically review the literature on the epidemiological association between CP and MS in adults. PRISMA 2020 statement was used in the study protocol. The design was done according to the Cochrane methodology. A comprehensive literature search was performed in PubMed, Scopus and Cochrane databases; a manual search and evaluation of the gray literature was also performed. The meta-analysis was performed by Review Manager (RevMan) 5.4. Odds ratio (OR) with 95% confidence interval (CI) was defined as the effect size of the outcome. Heterogeneity was assessed by Chi-square and I2. The articles evaluated were written in English, without a time limit, concern observational studies (patient-controls) and report the diagnostic criteria of the diseases. Duplicate entries were excluded. To evaluate the reliability of the results of each study, Newcastle-Ottawa Scale (NOS) and GRADE tools were used. Two independent reviewers did all evaluations with a resolution of discrepancies by a third. Meta-analysis included three observation studies examined 3376 people. MS patients are significantly more likely to be diagnosed with CP than healthy controls (OR 1.93, 95% CI 1.54-2.42, p<0.0001). A high prevalence of CP was found among MS patients compared with healthy controls. Healthcare professionals should be aware of the association between these pathological entities to provide patients with high-quality care through an effective and holistic diagnostic and therapeutic approach.

Recent advances in JAK inhibitors for the treatment of metabolic syndrome.

With an epidemic spread, metabolic syndrome represents an increasingly emerging risk for the population globally, and is currently recognized as a pathological entity. It is represented by a cluster of different conditions including increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol or triglyceride levels. These conditions lead directly to several disorders, including obesity, dyslipidemia, hyperglycaemia, insulin resistance, impaired glucose tolerance and hypertension causing an increase in cardiovascular risk and in particular atherosclerotic disease. Despite efforts to promote healthier lifestyles through exercise, reduced caloric intake, and improved dietary choices, the incidence and prevalence of metabolic syndrome continue to rise worldwide. Recent research has highlighted the involvement of signaling pathways in chronic inflammatory conditions like obesity and type 2 diabetes mellitus, revealing the significance of the JAK/STAT pathway in atherosclerotic events. This pathway serves as a rapid membrane-to-nucleus signaling module that regulates the expression of critical mediators. Consequently, JAK inhibitors (JAKi) have emerged as potential therapeutic options for metabolic diseases, offering a promising avenue for intervention. The aim of this review is to shed light on the emerging indications of JAK inhibitors in metabolic syndrome, emphasizing their potential role in attenuating associated inflammatory processes, improving insulin sensitivity, and addressing cross-talk with the insulin pathway, with the intention of contributing to efforts in the field of inflammation pharmacology.

Accessory cardiac bronchus with associated lung parenchyma: rare congenital tracheobronchial anomaly.

Accessory cardiac bronchus (ACB) has been described mainly as case reports finding (frequency 0.08%-0.39%). Even though 50% of all ACBs have a blind extremity, imaging studies have demonstrated that some develop into a series of bronchioles with cystic degeneration or a ventilated lobule demarcated by an anomalous fissure and extremely rare with an abnormal pulmonary artery. In this case, ACB was demonstrated on several imaging methods arising from the intermediate bronchus's medial wall with correspondent blood vessels and fissure. Although an ACB is not a pathological entity and most patients with ACB are asymptomatic, it can become symptomatic due to recurrent infection, empyema, hemoptysis, and malignant transformation. In conclusion, both pulmonologists and radiologists should recognize normal bronchial anatomy and developmental bronchial anomalies, as these may be important to establish a correct diagnosis.

HIATAL HERNIA, PANORAMIC REVIEW OF DIAGNOSIS AND MANAGEMENT

Introduction: Hiatal hernia (HH) occurs frequently in the population, characterized by various non-specific symptoms, however most of these symptoms are found to be related to gastroesophageal reflux disease. A hiatal hernia is said to be a medical condition in which the upper portion of the stomach or other internal organ protrudes through an opening in the diaphragm. Objective: to detail current information related to hiatal hernia, description, etiology, classification, diagnosis, differential, prognosis, management and complications. Methodology: a total of 38 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 27 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: hiatal hernia, hiatal repair, diagnosis, management. Results: The incidence of symptomatic cases of hiatal hernia is related to the diagnosis of gastroesophageal reflux disease (GERD). The incidence of hiatal hernias increases with age. About 55%-60% of individuals over 50 years of age have a hiatal hernia. However, approximately 9% have symptoms and it depends on the type and competence of the lower esophageal sphincter (LES). The largest percentage of these hernias are type I sliding hiatal hernias. Type II, paraesophageal hernias, represent approximately 5% of hiatal hernias in which the LES remains stationary, with the stomach protruding superiorly to the diaphragm. There is also a high prevalence in women, attributable to increased intra-abdominal pressure during pregnancy. The estimated overall 30-day mortality rate in relation to antireflux surgery is approximately 0.19%. Conclusions: Hiatal hernia (HH) is relatively common in the general population. It is caused by increased intra-abdominal pressure, leading to protrusion of the stomach and other abdominal viscera into the mediastinum. Hiatal hernias can be congenital or acquired. The current anatomical classification of hiatal hernias consists of four types or categories, each with its different characteristics. Diagnosis of hiatal hernia can be challenging because of the change in the anatomy of the esophagogastric junction on swallowing, breathing and movement. The pre-surgical study of the individual supports the diagnosis and the exclusion of other pathologic entities to properly direct the surgical intervention. The success of hiatal hernia surgery can be measured by the improvement of symptoms, such as esophageal acid exposure, complications and the requirement for reoperation. Complications of surgery are usually mild and are not directly linked to the surgery itself. KEY WORDS: surgery, hernia, hiatus, diagnosis, management.

Multidisciplinary Approach and Therapeutic Advances in the Management of Meningioma: A Comprehensive Review

Meningioma, a predominantly benign intracranial neoplasm originating in the meninges, has been the subject of extensive study in the medical community due to its prevalence, clinical diversity, and associated therapeutic challenges. This article aims to provide a comprehensive review of current advances in the understanding, diagnosis and treatment of meningiomas, focusing on the application of multidisciplinary approaches and innovative therapies. Through a detailed exploration of the molecular pathogenesis, updated histopathologic classifications, and varied clinical presentations of meningiomas, an in-depth understanding of the inherent heterogeneity of these neoplasms is sought. The importance of advanced neuroimaging, including diffusion-weighted MRI and positron emission tomography, in the accurate assessment of tumor extent and precise surgical planning will be highlighted. In the therapeutic arena, conventional options, such as surgery and radiation therapy, will be examined in detail and the challenges and limitations associated with these modalities will be discussed. In addition, emerging pharmacologic therapies, such as angiogenesis inhibitors and therapies specifically targeting genetic mutations frequently found in meningiomas, will be reviewed, highlighting their potential to modify the clinical course of the disease. The multidisciplinary approach, involving close collaboration between neurosurgeons, neuroradiologists, pathologists and oncologists, will be explored in detail, highlighting its crucial role in informed clinical decision making and optimizing patient outcomes. Finally, future prospects and areas of ongoing research, such as immunotherapy and gene therapy, which promise to further revolutionize the therapeutic paradigm for meningiomas, will be outlined. This article will provide a comprehensive overview of meningiomas, from their molecular basis to state-of-the-art treatment strategies, with the purpose of enriching medical knowledge and fostering a holistic approach in the care of patients affected by this complex pathological entity.

Cervical intramedullary spinal cord metastasis from esophageal adenocarcinoma: a case report

BackgroundIntramedullary spinal cord metastasis (ISCM) is a rare pathologic entity. To the best of our knowledge, this is the second case of ISCM due to esophageal adenocarcinoma reported in the literature.Case descriptionWe report a 63-year-old man with a history of surgical removal of an esophageal adenocarcinoma who presented with the Brown–Sequard syndrome. Pan-spinal MRI showed intramedullary cervical lesions with intense homogeneous enhancement on gadolinium injection at C3 level. There were other sites of spinal metastases and one in the brain. We proceeded with the surgical removal of the lumbar metastatic lesion. The patient died 10 days later from respiratory failure.ConclusionISCM from esophageal adenocarcinoma appeared as homogeneous high intensity of the intramedullary lesion in T1 gadolinium. Their prognosis is very poor.

Fibrillary Glomerulonephritis with Prevalent IgA Deposition Associated with Psoriasis

Abstract Fibrillary and immunotactoid glomerulonephritis represent the pathological entities characterized by structured fibrillary/microtubular deposits, whose identification is possible only by electron microscopy. We report a 46-year-old female who presented with proteinuria 15 years after the onset of psoriasis. Diffuse global glomerulosclerosis pattern was noted on light microscopy. In immunofluorescence microscopy, predominant IgA deposition was observed and electron microscopy showed organized randomly arranged fibrillary deposits with diameter ranging between 10 and 23 nm in mesangial, subendothelial, intramembranous, and subepithelial sites.

Clinical outcome and therapeutic impact on neuroendocrine neoplasms of the breast: a national cancer database study.

Neuroendocrine neoplasms (NENs) of the breast are rare and not well-studied. NEN are subcategorized as well-differentiated neuroendocrine tumor (NET) and poorly differentiated neuroendocrine carcinoma (NEC). The objectives of the current study were to review the clinicopathologic features of NENs, therapeutic efficacy of current systemic therapy and clinical outcomes of NEN of the breast. Between 2004 and 2015, 420 NET, 205 NEC, 146 Adenocarcinoma with NE differentiation (ACNED) and 1,479,520 of invasive carcinoma, not otherwise specified (IC-NOS) of the breast were identified in the National Caner Database. Overall survival was compared among groups using Kaplan-Meier method and Log-rank test. Multivariate analyses were performed to identify prognostic factors. After adjusting for other prognostic factors, both NET and NEC of the breast showed significantly worse OS than IC-NOS (HR (95% CI) = 1.41 (1.17, 1.72), p = 0.005 and HR (95% CI) = 2.11 (1.67, 2.67), p < 0.001, respectively). Both NET and NEC benefited from endocrine therapy if the tumors were hormonal receptor positive (median OS for treated with vs without: 125 vs 57months in NET, not reached vs 29months in NEC). NEC also benefited from chemotherapy (median OS for treated with vs without: 42 vs 34months), but not NET. NEN is a unique pathologic and clinical entity, which has worse clinical outcome compared to IC-NOS of the breast. Current therapeutics used in the treatment of IC-NOS improve, but do not fully mitigate, the poorer prognosis of NEN patients. More effective therapy for patients with this unique tumor type are needed.

Frontotemporal lobar degeneration.

Frontotemporal lobardegeneration (FTLD)is one of the most common causes of early-onset dementia and presents with early social-emotional-behavioural and/or language changes that can be accompanied by a pyramidal or extrapyramidal motor disorder. About 20-25% of individuals with FTLD are estimated to carry a mutation associated with a specific FTLD pathology. The discovery of these mutations has led to important advances in potentially disease-modifying treatments that aim to slow progression or delay disease onset and has improved understanding of brain functioning. In both mutation carriers and those with sporadic disease, the most common underlying diagnoses are linked to neuronal and glial inclusions containing tau(FTLD-tau) or TDP-43 (FTLD-TDP), although 5-10% of patients may have inclusions containing proteins from the FUS-Ewing sarcoma-TAF15 family (FTLD-FET). Biomarkers definitively identifying specific pathological entities in sporadic disease have been elusive, which has impeded development of disease-modifying treatments. Nevertheless, disease-monitoring biofluid and imaging biomarkers are becoming increasingly sophisticated and are likely to serve as useful measures of treatment response during trials of disease-modifying treatments. Symptomatic trials using novel approaches such as transcranial direct current stimulation are also beginning to show promise.

Mucinous Colorectal Carcinoma Arising in Nonulcerated Villous Adenoma (MAVA): A Distinct Pathologic Entity

Among 209 surgical specimens of resectable colorectal adenocarcinomas, nine mucinous carcinomas arising in nonulcerated villous adenoma (MA VA) were identified. They showed infUtration in the colorectal muscillaris própria or through it. However, their morphology was similar to the so-called pseudocarcinomatous submucous foci of villous adenomas. Only one of these tumors had lymph-node metastasis. We suggest that the mechanism of invasion of the colorectal wall in MAMA is diferent from that of the common adenocarcinoma, not implying an authentic carcinomatous transformation at cellular level.

A case of canine intestinal malakoplakia

Malakoplakia is a rare chronic granulomatous disease usually affecting the urinary bladder and other locations. In humans, the gastrointestinal tract is the second most common location but there are no reports of intestinal malakoplakia in animals. A 10-month-old female French Bulldog was presented with chronic haemorrhagic diarrhoea and anorexia with normochromic-normocytic anaemia and hypoalbuminaemia. Grossly, there was mucosal thickening and ulceration of the caecum, colon and rectum. Microscopically, transmural sheets of foamy macrophages were seen in these tissues. Macrophages were periodic acid–Schiff, vimentin and ionized calcium-binding adaptor molecule 1 positive and contained von Kossa- and Prussian blue-positive Michaelis–Gutmann bodies. Giemsa staining revealed rod-shaped bacterial colonies and fluorescence in-situ hybridization demonstrated Escherichia coli within macrophages. This is the first reported case of intestinal malakoplakia in domestic animals. Pathological features of intestinal malakoplakia share many similarities with ulcerative histiocytic colitis in dogs but it is unclear if they are different forms of the same pathological process or distinct entities.

Use of patient-specific 3D printed models in pre-operative counseling for pediatric skull base surgery.

Pediatric cranial base pathology is anatomically complex and surgical treatment is oftentimes difficult to conceptualize for patients and their families. Three-dimensional (3D) models of the sinuses and cranial base have the potential to enhance patient understanding in numerous domains. Our objective is to assess the use of 3D models in pre-operative parental and patient counseling prior to endoscopic endonasal skull base surgery in the pediatric population. A survey was designed to assess parent and patient-perceived utility of 3D-printed models in surgical counseling prior to pediatric skull base surgery. A total of 10 patients were included. The median age was 9 years (range=5 months-15 years). Pathology included juvenile nasopharyngeal angiofibroma (JNA) (N=4), fibrous dysplasia of the maxilla and sphenoid (N=1), juvenile ossifying fibroma (N=1), nasal dermoid (N=2, one with intracranial extension), encephalocele (N=1), and parapharyngeal ectopic glial tissue (N=1). Nearly all parents agreed or strongly agreed that 3D printed models were helpful in explaining the patient's skull base pathology (N=10), surgical plan (N=10), and possible complications (N=9). All parents strongly agreed that 3D models should be used routinely in pre-operative counseling for endoscopic endonasal surgery. According to a majority of parents, patients older than 4 years old found the models helpful in understanding their pathology (75%) and surgery (88%). By allowing direct three-dimensional visualization of the target pathology, 3D models serve as a useful adjunct in enhancing patient comprehension of the pathologic entity, planned surgery, and potential complications prior to pediatric endoscopic endonasal skull base surgery.

ACUTE CORONARY SYNDROME REVEALING AN ECTATIC CORONARY NETWORK: THE CHALLENGES OF MANAGEMENT (CASE REPORT)

Coronary ectasia is relatively a rare pathological entity, whose pathophysiological mechanisms and management principles are still poorly understood. Atherosclerosis is the predominant etiology with other causes that can be incriminated at lower percentages. These abnormalities expose to a major risk of intracoronary thrombosis by blood stasis, especially since they are most often associated with stenotic lesions conditioning the prognosis of patients. We report the case of a patient admitted to the emergency room for the management of an acute coronary syndrome without ST segment elevation with on coronary angiography an aspect of diffuse coronary ectasia affecting the 3 main coronary arteries, and we discuss a review of the literature concerning this type of condition and specifics of management.

Mucosal appendicitis : How can it be differentiated from nonappendicitis?

Mucosal appendicitis is defined by neutrophilic infiltration limited to the mucosa, with no transmural invasion; it is currently a controversial entity. The aim of our study was to determine whether mucosal appendicitis represents an early stage of acute appendicitis (AA) or should be considered a negative appendectomy. A retrospective study was performed of children with suspected AA who underwent surgical treatment between 2017 and 2020. The participants were divided into 2 groups according to histologic appendiceal findings: mucosal appendicitis (MA) and negative appendicitis (NA). Demographic, clinical, ultrasound, and laboratory features were compared between the groups. A total of 1269 patients with suspected appendicitis in whom appendectomy was performed were included, with a median age of 10.5 years. Mucosal appendiceal inflammation was histologically confirmed in 30 cases (MA group), while no inflammation or other pathologic findings were observed in 25 cases (NA group), with no differences in demographic, clinical, or ultrasound features between the groups. Those in the MA group presented with significantly higher leukocyte and neutrophil counts and higher neutrophil to lymphocyte ratios (NLRs) than those in the NA group (P < .001). The NLR was the parameter with the highest area under the curve (0.736) for the diagnosis of MA. A cutoff of 3.20 was established, with a maximum sensitivity and specificity of 62.5% and 78.9%, respectively. Mucosal appendicitis presents with laboratory and histologic inflammatory features that can be distinguished from nonappendicitis and should therefore be considered a pathologic entity within the spectrum of AA. Preoperative leukocyte and neutrophil counts and NLRs may help reduce the number of negative appendectomies.

Development of Therapy Based on the Exploration of Biological Events Underlying the Pathogenetic Mechanisms of Chronic Hepatitis B Infection.

According to the World Health Organization (WHO), an estimated 296 million people are chronically infected with hepatitis B virus (HBV). Approximately 15-25% of these people develop complications such as advanced chronic liver diseases (ACLDs). Mortality due to HBV-related complications accounted for an estimated 882,000 deaths in 2019. Potent preventive vaccines have already restricted new HBV infections, and several drugs are available to treat chronic HBV infections. However, the positive impacts of these drugs have been recorded in only a few patients with chronic HBV infection. These drugs do not show long-term efficacy and cannot halt the progression to complications. Thus, more effective and evidence-based therapeutic strategies need to be urgently developed for patients with chronic HBV infection. CHB is a pathological entity induced by HBV that progresses due to impaired host immunity. This indicates the inherent limitations of antiviral-drug-based monotherapy for treating patients with chronic HBV infection. Additionally, commercially available antiviral drugs are not available to patients in developing and resource-constrained countries, posing a challenge to achieving the following WHO goal: "Elimination of Hepatitis by 2030". As such, this review aimed to provide insights regarding evidence-based and effective management strategies for chronic HBV infection.