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Underutilisation of antiviral therapy may contribute to this concerning trend but empirical data remain sparse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to assess the frequency of missed opportunities for antiviral therapy before HBV\u2010related HCC development and to investigate factors associated with non\u2010treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed the electronic medical records from a large healthcare group in Taiwan to identify all HBV\u2010infected patients who developed HCC between 1 April 2004 and 24 May 2022. HBV infection was confirmed by hepatitis B surface antigen seropositivity and incident HCC was verified through the cancer registry. Patients were grouped based on whether they had received antiviral therapy prior to the HCC diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1017 patients with HBV\u2010related HCC (median age, 60.8\u2009years; 80.1% male; 42.9% with cirrhosis), 75% had not received antiviral therapy before developing HCC. Compared to treated patients, the untreated group had a significantly lower proportion of cirrhosis (33.5% vs. 71.0%), higher platelet counts, elevated liver enzyme levels, and higher viral loads. They also had significantly fewer specialist visits (median frequency, 0.3 vs. 3.6 visits per year) and biomarker evaluations, and were less frequently diagnosed at early stages (Stage I\/II, 49.5% vs. 81.6%) with a significantly shorter median survival (2.1 vs. 4.4\u2009years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Three\u2010quarters of patients who developed HBV\u2010related HCC had not received antiviral therapy before HCC diagnosis. These patients were characterised by a lower proportion of cirrhosis, infrequent clinical visits, fewer HBV evaluations, more advanced HCC stage, and poorer prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.70224","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T11:24:14Z","timestamp":1749727454000},"page":"620-629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Factors Associated With Underutilization of Antiviral Therapy in Preventing Hepatitis B Virus\u2010Related Hepatocellular Carcinoma"],"prefix":"10.1111","volume":"62","author":[{"given":"Jia\u2010Ling","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Public Health National Cheng Kung University, College of Medicine  Tainan 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