Chronic hepatitis B: Prevent, diagnose, and treat before the point of no return

Table 1 Impact of Antiviral therapy on outcomes of patients with advanced stages of chronic hepatitis B

Ref.	Study design	Drug/duration	HBV patients number	Baseline cirrhosis	Main results
Fontana et al[18], 2002	Prospective	Lamivudine for 16 months	154	154 (DC)	78% had very high mortality due to complications of liver failure
Dienstag et al[38], 2003	Prospective	Lamivudine, 3 years	63	11	Cirrhosis regressed in 8 of 11 patients (73%)
Hadziyannis et al[37], 2006	Prospective	Adefovir, up to 240 weeks	125	4	58% had reversal of bridging fibrosis/cirrhosis; 3 had cirrhosis reversal
Schiff et al[39] 2008	Randomized	Entecavir/lamivudine for 48 weeks	1633	245	71% of Entecavir and 61.5% of lamivudine group showed fibrosis regression
Das et al[40], 2010	Retrospective-prospective	Lamivudine/adefovir	151	151 (DC)	Better 5 year survival rate in treated patients for > 6 months
Andersen et al[41], 2011	Prospective	Nucleoside(tide) analogues, 50.5 months	66	53	26 (49%) had regression of cirrhosis
Marcellin et al[9], 2013	Randomized	TDF/adefovir for 48 weeks then open-label TDF	641	96	71 of 96 (74%) became non-cirrhotic at 5 years
Du et al[42], 2013	Prospective	Lamivudine/adefovir for 44.5 months	48	33	23 (69%) patients had reversal of cirrhosis
Srivastava et al[43], 2013	Prospective	TDF 2 years	96	96 (DC)	MELD score of > 20 a/w 58 fold increased mortality
Papatheodoridis et al[16], 2018	Multicenter prospective	TDF/entecavir for 6 years	1951	526	Significant improvement in overall survival
Hsu et al[13] 2021	Randomized	TDF for 3 years	73	00	16%- reduced fibrosis, 58% non- progression
Desalegn et al[44], 2019	Prospective	TDF for 2 years	276	35 (DC)	24 fold increase in mortality if decompensated cirrhosis
Ismael et al[3], 2024	Prospective	TDF	193	35 (DC)	60% of all death occurred due to decompensated liver disease with in first 6 months

HBV: Hepatitis B virus; DC: Decompensated cirrhosis; TDF: Tenofovir disoproxil fumarate; MELD: Model for end-stage liver disease.