Nucleos(t)ide analogue (NA) therapy notably decreases cirrhosis and hepatocellular carcinoma (HCC) incidence in HBeAg-positive chronic HBV patients outside current EASL 2025 strong treatment indications.
The protective effect is most pronounced in patients with high viral replication or impending phase transition, identified by specific virologic and clinical parameters.
No significant benefit of NA therapy was observed in HBeAg-negative individuals with low or moderate viral replication and normal liver enzymes without fibrosis.
Findings support revising treatment criteria to include broader patient subsets to prevent severe liver outcomes.
