Most of those with advanced hepatitis B are not treated with antiviral medications
December 3, 2025
Summary: Most of those who are diagnosed with liver disease from hepatitis B are not treated with antivirals that could prevent further liver damage and make premature death less likely.
Source: Wong, et al JAMA Network Open November 19, 2025; HBV = Hepatitis B Virus; LFT = Liver Function Tests
Hepatitis B prevalence in the U.S. population has declined dramatically since the early 1980s, when the first Hepatitis B vaccinations became available. Most of those who are infected with hepatitis B recovery fully, although a small portion continue to have the virus present in their blood. This increases the risk of liver cancer by 10-25%, and increases the risk of premature death. Further, those with hepatitis B viremia can infect others.
There is no drug that “cures” hepatitis B. However, antiviral agents can suppress the virus, and protect against liver cancer, liver failure, and premature death.
Nonetheless, most people who are eligible for treatment for hepatitis B do not receive it. Researchers reviewed a database of over 75 million de-identified patient records, and identified 8594 who met inclusion criteria, but only 2134 (24.8%) received antiviral treatment. Women, Black people and younger adults were least likely to be treated. Treating pregnant women to avoid vertical transmission to newborns during birth is especially important, but the researchers did not report on the likelihood of treatment of pregnant women. The research was published in JAMA Network Open.
Implications for employers:
Hepatitis B continues to lead to increased risk of liver failure and liver cancer, and many with chronic hepatitis B are not treated with antiviral medications.
The most effective way to prevent chronic hepatitis B is vaccination of all newborns, regardless of the hepatitis B status of their mothers.
Employers can support and encourage members to have at least 1 screening during their adult lifetime, as recommended by the US Preventive Services Task Force.