Hepatitis B outside treatment criteria: two groups may still benefit from antivirals

The edition in brief

A cohort of 30,784 people with chronic hepatitis B across 12 Chinese centres examined those outside the 2025 EASL strong treatment indications. Nucleos(t)ide analogue therapy was associated with much lower cirrhosis and hepatocellular carcinoma risk in HBeAg-positive patients with very high viral load and normal ALT under 30 (cirrhosis HR 0.18; HCC HR 0.03), and in HBeAg-positive patients over 30 approaching phase transition (cirrhosis HR 0.50; HCC HR 0.25), but not in HBeAg-negative low-replicative groups. A single-arm phase 2 study of eight weeks of bemnifosbuvir plus ruzasvir in 275 treatment-naive hepatitis C patients of any genotype reported SVR12 of 90% by intention to treat and 98% in adherent patients, including those with cirrhosis or NS5A resistance variants. A meta-analysis of plecanatide in chronic idiopathic constipation and IBS-C found more complete spontaneous bowel movements at all doses, with diarrhoea the main reason for stopping and 3 mg giving the best balance.