Hepatitis B treatment shifts focus to viral load to prevent liver cancer

New medical guidelines are shifting the treatment strategy for chronic Hepatitis B from managing liver inflammation to early suppression of viral replication. According to updated 2026 clinical guidelines, the primary criterion for deciding antiviral treatment is moving from liver enzyme levels (ALT) to viral load (HBV DNA).

Research indicates that patients with moderate viremia—those with blood viral loads between 2,000 and 10^8 IU/mL—face a high risk of liver damage and hepatocellular carcinoma, even when liver enzyme levels appear normal. Clinical studies involving South Korean and Taiwanese cohorts have shown that early antiviral intervention significantly reduces the risk of severe clinical events, including liver cancer, decompensated liver disease, and death.

In South Korea, an estimated 1.2 million people live with chronic Hepatitis B. While the diagnosis rate is approximately 83%, the actual treatment rate remains low at 22.2%. Experts emphasize that because chronic infection can lead to cirrhosis and liver failure, patients should undergo regular screenings, including liver ultrasounds and blood tests every six months, even if the virus is being suppressed by medication.