Hepatitis B outside current treatment criteria: antivirals were linked to far less cirrhosis and HCC in HBeAg-positive patients

The edition in brief

A 12-centre Chinese cohort of 30,784 people with chronic hepatitis B who fell outside the 2025 EASL strong treatment criteria found nucleos(t)ide analogue therapy was associated with much lower risks of cirrhosis and hepatocellular carcinoma in HBeAg-positive patients with very high viral loads (HCC HR 0.03) and in those approaching phase transition (HCC HR 0.25), but not in HBeAg-negative low-replicative groups. In the US ALTUS study of 2,293 adults under HCC surveillance, a multi-target blood test detected 66.7% of early-stage cancers against 22.2% for ultrasound, though its specificity of 81.8% narrowly missed its target, against 98.6% for ultrasound. A meta-analysis of 30 studies found crown-tipped (Franseen) EUS needles nearly tripled the odds of an adequate sample and gave optimal histological cores in 89%, with fewer passes and similar safety. A single-centre surveillance study of 222 endoscope uses found reprocessing success of 90.5% to 95.9% across three disinfectants, with repeated failures traced to individual scopes.