{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:11:04Z","timestamp":1790187064176,"version":"4.1.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Comparative outcomes of HBV-infected compensated cirrhosis with low-level viremia (LLV) versus maintained virological response (MVR) are unclear. We conducted a large, multiethnic, multicenter study to examine the natural history of LLV versus MVR in compensated cirrhosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients and Methods:<\/jats:title>\n            <jats:p>We enrolled patients with HBV-infected compensated cirrhosis (n=2316) from 19 hospitals in South Korea, Singapore, and Japan. We defined the LLV group as untreated patients with \u22651 detectable serum HBV-DNA (20\u20132000\u00a0IU\/mL), Spontaneous-MVR group as untreated patients with spontaneously achieved MVR, and antiviral therapy (AVT)-MVR group as patients achieving AVT-induced MVR. Study end points were HCC or hepatic decompensation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The annual HCC incidence was 2.7\/100 person-years (PYs), 2.6\/100 PYs, and 3.3\/100 PYs for LLV (n=742), Spontaneous-MVR (n=333), and AVT-MVR (n=1241) groups, respectively (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.81 between LLV vs. Spontaneous-MVR groups and <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.37 between LLV vs. AVT-MVR groups). Similarly, the annual decompensation incidence was 1.6\/100 PYs, 1.9\/100 PYs, and 1.6\/100 PYs for LLV, Spontaneous-MVR, and AVT-MVR groups, respectively (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.40 between LLV vs. Spontaneous-MVR groups and <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.83 between LLV vs. AVT-MVR groups). Multivariable analyses determined that HCC and decompensation risks in the LLV group were comparable to those with Spontaneous-MVR and AVT-MVR groups (all <jats:italic toggle=\"yes\">p<\/jats:italic> &gt;0.05). Propensity score matching also reproduced similar results for HCC and decompensation risks (all <jats:italic toggle=\"yes\">p<\/jats:italic>&gt;0.05 between LLV vs. Spontaneous-MVR groups and between LLV vs. AVT-MVR groups).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Untreated LLV in HBV-infected compensated cirrhosis is not associated with increased risk of disease progression compared with Spontaneous-MVR and AVT-MVR. These data have important implications for practice and further research.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/hep.0000000000000037","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T15:08:24Z","timestamp":1673536104000},"page":"1746-1756","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":18,"title":["Outcome of untreated low-level viremia versus antiviral therapy-induced or spontaneous undetectable HBV-DNA in compensated cirrhosis"],"prefix":"10.1097","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5165-5061","authenticated-orcid":false,"given":"Daniel Q.","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Division of Gastroenterology and Hepatology, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4634-6616","authenticated-orcid":false,"given":"Nobuharu","family":"Tamaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6958-3035","authenticated-orcid":false,"given":"Hyung Woong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4944-4396","authenticated-orcid":false,"given":"Soo Young","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1916-1448","authenticated-orcid":false,"given":"Yu Rim","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3552-3560","authenticated-orcid":false,"given":"Hye Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0994-4932","authenticated-orcid":false,"given":"Seng Gee","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Division of Gastroenterology and Hepatology, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4578-8685","authenticated-orcid":false,"given":"Tae Seop","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7016-8931","authenticated-orcid":false,"given":"Masayuki","family":"Kurosaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4286-2712","authenticated-orcid":false,"given":"Hiroyuki","family":"Marusawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4377-4829","authenticated-orcid":false,"given":"Toshie","family":"Mashiba","sequence":"additional","affiliation":[{"name":"Center for Liver-Biliary-Pancreatic Disease, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0435-4909","authenticated-orcid":false,"given":"Masahiko","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japanese Red Cross Otsu Hospital, Otsu, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7998-2427","authenticated-orcid":false,"given":"Yasushi","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Matsue Red Cross Hospital, Matsue, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4313-6808","authenticated-orcid":false,"given":"Haruhiko","family":"Kobashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japanese Red Cross Okayama Hospital, Okayama, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Furuta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Masuda Red Cross Hospital, Masuda, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0055-8229","authenticated-orcid":false,"given":"Namiki","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5363-2496","authenticated-orcid":false,"given":"Beom Kyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7126-5554","authenticated-orcid":false,"given":"Dong Hyun","family":"Sinn","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"key":"R1-20250824","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s12072-007-5001-0","article-title":"Natural course following the onset of cirrhosis in patients with chronic hepatitis B: a long-term follow-up study","volume":"1","author":"Chen","year":"2007","journal-title":"Hepatol 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