Evidence map›Paper›PMID 42366559›Full record

ReviewClinical and molecular hepatology2026

Comparison of clinical practice guidelines for chronic hepatitis B: natural history classification and treatment initiation.

Gi-Ae Kim, Won-Mook Choi, Gwang Hyeon Choi, In Hee Kim, Tatsuya Kanto, Ming-Lung Yu, Young-Suk Lim

Abstract readReviewComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Review in Clinical and molecular hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Gi-Ae Kim *Department of Internal Medicine, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea.
Won-Mook Choi *Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Gwang Hyeon Choi *Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
In Hee KimDepartment of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University College of Medicine, Jeonju, Korea.
Tatsuya KantoDepartment of Liver Diseases, The Research Center for Hepatitis and Immunology, National Institute of Global Health and Medicine, Japan Institute for Health Security, Chiba, Japan.
Ming-Lung YuHepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Young-Suk LimDepartment of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. limys@amc.seoul.kr.

Funding

Ministry of Health and Welfare RS-2025-02217627Patient-Centered Clinical Research Coordinating Center
6 · The paper itself

Abstract

International and regional clinical practice guidelines (CPGs) for chronic hepatitis B (CHB) have recently been updated to incorporate evolving clinical evidence. This review compares the latest major CPGs regarding natural history classification, treatment initiation, and selection of antiviral agents, specifically focusing on updates from the Korean Association for the Study of the Liver-East Asia Liver Alliance (KASL-EALA), the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver (EASL), and the World Health Organization (WHO). While all guidelines recognize the heterogeneous and dynamic nature of CHB, managing patients in the "grey zone" or indeterminate phase remains a major challenge. The KASL-EALA 2026 guideline introduces a novel framework based primarily on hepatitis B virus (HBV) DNA levels-independent of alanine aminotransferase criteria-eliminating the indeterminate category to better align with hepatocellular carcinoma risks and simplify treatment decision-making. In contrast, AASLD 2025, EASL 2025, and WHO 2024 retain conventional immunological phase-based classifications for natural history. For treatment indications, all four guidelines advocate broader access to antiviral therapy despite their divergent structural approaches. AASLD suggests shared decision-making, EASL emphasizes individualized risk assessment, and WHO 2024 abandons the phase-based framework for treatment decisions entirely. Understanding these key similarities and differences will help clinicians optimize patient care and inform future efforts toward global harmonization in CHB management.

Indexed as

Hepatitis B, ChronicPractice Guidelines as TopicAlanine TransaminaseAntiviral AgentsCarcinoma, HepatocellularDNA, ViralHepatitis B virusHumansLiver NeoplasmsWorld Health OrganizationAlanine TransaminaseAntiviral AgentsDNA, ViralChronic hepatitis BGuidelinesNatural historyTreatment

Identifiers

PMID42366559
PMCPMC13430321

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.