{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T12:18:21Z","timestamp":1787833101239,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004608","name":"Natural Science Foundation of Jiangsu Province","doi-asserted-by":"publisher","award":["BK20251727"],"award-info":[{"award-number":["BK20251727"]}],"id":[{"id":"10.13039\/501100004608","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Current guidelines for chronic hepatitis B (CHB) have progressively expanded antiviral treatment indications, with age &gt;\u200930\u2009years increasingly being incorporated as an important criterion. However, real\u2010world evidence regarding treatment outcomes in this expanded population remains limited. This study evaluated the 48\u2010week treatment response and its independent predictors in treatment\u2010na\u00efve CHB patients aged &gt;\u200930\u2009years with a high baseline viral load. This retrospective study included 808 treatment\u2010na\u00efve CHB patients aged &gt;\u200930\u2009years with baseline HBV DNA \u2265\u20092000\u2009IU\/mL who received first\u2010line nucleos(t)ide analogue (NA) monotherapy. Patients were classified into moderately high (MH; \u2265\u20092\u2009\u00d7\u200910\n                    <jats:sup>3<\/jats:sup>\n                    to &lt;\u20091\u2009\u00d7\u200910\n                    <jats:sup>7<\/jats:sup>\n                    \u2009IU\/mL) and extremely high (EH; \u2265\u20091\u2009\u00d7\u200910\n                    <jats:sup>7<\/jats:sup>\n                    \u2009IU\/mL) viral load groups. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to adjust for baseline imbalance. At week 48, the overall virological response (VR) rate was 90.0% (727\/808). Among HBeAg\u2010positive patients at baseline, the HBeAg seroclearance and seroconversion rates were 14.0% (59\/422) and 11.8% (50\/422), respectively. Compared with the MH group, the EH group had significantly lower rates of VR (81.8% vs. 95.5%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), HBeAg seroclearance (9.4% vs. 22.6%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and HBeAg seroconversion (7.2% vs. 20.5%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Multivariable Cox regression analysis showed that ALT \u2265\u20095\u2009\u00d7\u2009ULN was independently associated with a higher likelihood of VR, whereas HBeAg positivity and HBV DNA \u2265\u20091\u2009\u00d7\u200910\n                    <jats:sup>7<\/jats:sup>\n                    \u2009IU\/mL were independently associated with a lower likelihood of VR. These associations remained robust after PSM and IPTW adjustment. First\u2010line NA therapy achieved a favourable 48\u2010week VR in CHB patients aged &gt;\u200930\u2009years with a high viral load. However, HBeAg positivity and extremely high viral load were associated with suboptimal response, supporting intensified monitoring and individualised management.\n                  <\/jats:p>","DOI":"10.1111\/jvh.70226","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T13:22:49Z","timestamp":1787577769000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Virologic Response to Antiviral Therapy in Chronic Hepatitis B Patients With High Viral Load: A Real\u2010World Cohort Study"],"prefix":"10.1111","volume":"33","author":[{"given":"Siwei","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing Clinical Teaching Hospital of Medical School, Nanjing University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueyan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing Clinical Teaching Hospital of Medical School, Nanjing University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6633-6795","authenticated-orcid":false,"given":"Hongli","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2957-500X","authenticated-orcid":false,"given":"Tianhao","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4497-7916","authenticated-orcid":false,"given":"You","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xixuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing Teaching Hospital of Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1575-1574","authenticated-orcid":false,"given":"Yijun","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1844-0892","authenticated-orcid":false,"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anling","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, The Affiliated Nanjing No. 2 Clinical College of Xuzhou Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qunzeng","family":"Danzeng","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing Teaching Hospital of Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialuo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing Teaching Hospital, Nanjing Medical University School of Public Health  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6746-9389","authenticated-orcid":false,"given":"Qingfang","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3214-0038","authenticated-orcid":false,"given":"Yongfeng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing Clinical Teaching Hospital of Medical School, Nanjing University  Nanjing China"},{"name":"Department of Infectious Disease and Liver Disease The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12985\u2010021\u201001706\u2010w"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.54394\/CJQU6666"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0780"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000060"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000001407"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102025\u2010337558"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.07.036"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2025.11.005"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.03.021"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29800"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2025.03.018"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000001549"},{"issue":"6","key":"e_1_2_14_14_1","first-page":"1425","article-title":"Guidelines for the Prevention and Treatment of Chronic Hepatitis B (Version 2022)","volume":"11","author":"Chinese Society of Hepatology, Chinese Medical Association","year":"2023","journal-title":"Journal of Clinical and Translational Hepatology"},{"issue":"6","key":"e_1_2_14_15_1","first-page":"915","article-title":"The Comparative Analysis of Two Real\u2010Time Quantitative Polymerase Chain Reaction Instruments in the Accreditation","volume":"25","author":"Wang F.","year":"2018","journal-title":"Labeled Immunoassays in Clinical Medicine"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2025.2552718"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478\u20103231.2008.01766.x"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13957"},{"issue":"7","key":"e_1_2_14_19_1","article-title":"Association Between Hepatitis B Virus Infection and Liver Metastasis in Colorectal Cancer","volume":"5","author":"Le C.","year":"2024","journal-title":"MedCommunications"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15112936"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-025-10833-3"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-025-10785-8"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12985-025-02981-7"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2023.311"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-72986-9"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072\u2010010\u20109227\u2010x"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13449"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-76270-8"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1556547"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/v14112404"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00046\u201019"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26277"}],"container-title":["Journal of Viral Hepatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.70226","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jvh.70226","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.70226","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:25:50Z","timestamp":1787829950000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jvh.70226"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":31,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/jvh.70226"],"URL":"https:\/\/doi.org\/10.1111\/jvh.70226","archive":["Portico"],"relation":{},"ISSN":["1352-0504","1365-2893"],"issn-type":[{"value":"1352-0504","type":"print"},{"value":"1365-2893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]},"assertion":[{"value":"2026-05-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70226"}}