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Treatment strategies for patients with hepatitis B virus infection coexisting with hepatitis C virus or metabolic

Chieh Liu1, Yi-Fen Shih2, Chun-Jen Liu3,4,5

  • 1Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Clinical and Molecular Hepatology
|January 9, 2026
PubMed

Insights

Hepatitis B virus (HBV) coinfection with hepatitis C virus (HCV) is declining, but co-occurrence with metabolic dysfunction-associated steatotic liver disease (MASLD) is rising. This review compares clinical outcomes and management of these HBV comorbidities.

Area of Science:

  • Hepatology
  • Virology
  • Metabolic Diseases

Background:

  • Hepatitis B virus (HBV) is a primary cause of chronic liver disease globally.
  • Coinfection with hepatitis C virus (HCV) and metabolic dysfunction-associated steatotic liver disease (MASLD) are significant comorbidities in HBV patients.
  • While HBV/HCV coinfection declines, MASLD is increasingly prevalent due to metabolic risk factors.

Purpose of the Study:

  • To compare the epidemiology, clinical outcomes, and management of HBV patients with concurrent HCV versus MASLD.
  • To identify research gaps and propose future research directions for these HBV comorbidities.

Main Methods:

  • This review critically analyzes existing literature on HBV/HCV coinfection and HBV/MASLD overlap.
  • Comparative analysis of epidemiological data, clinical outcomes, and therapeutic strategies was performed.

Main Results:

  • HBV/HCV coinfection leads to severe liver damage, with challenges in antiviral treatment and HBV reactivation risk.
  • HBV/MASLD interactions influence viral replication, HBsAg seroclearance, fibrosis, and hepatocellular carcinoma risk.
  • MASLD is emerging as the predominant comorbidity in HBV patients.

Conclusions:

  • Understanding the distinct impacts of HCV and MASLD on HBV infection is crucial for patient management.
  • Further research is needed to address complex metabolic-viral interactions and optimize treatment strategies for HBV/MASLD.
  • Effective management strategies must consider the evolving landscape of HBV comorbidities.

Keywords:
hepatitis B virushepatitis C virusmetabolic dysfunctionsteatohepatitissteatosis

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