{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T12:33:57Z","timestamp":1793018037052,"version":"4.5.0"},"reference-count":50,"publisher":"The Korean Association for the Study of the Liver","issue":"3","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Patient-Centered Clinical Research Coordinating Center"},{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["RS-2025-02217627"],"award-info":[{"award-number":["RS-2025-02217627"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-cmh.org"],"crossmark-restriction":true},"short-container-title":["Clin Mol Hepatol"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:p>International and regional clinical practice guidelines (CPGs) for chronic hepatitis B (CHB) have recently been updated to incorporate evolving clinical evidence. This review compares the latest major CPGs regarding natural history classification, treatment initiation, and selection of antiviral agents, specifically focusing on updates from the Korean Association for the Study of the Liver-East Asia Liver Alliance (KASL-EALA), the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver (EASL), and the World Health Organization (WHO). While all guidelines recognize the heterogeneous and dynamic nature of CHB, managing patients in the \u201cgrey zone\u201d or indeterminate phase remains a major challenge. The KASL\u2013EALA 2026 guideline introduces a novel framework based primarily on hepatitis B virus (HBV) DNA levels\u2014independent of alanine aminotransferase criteria\u2014eliminating the indeterminate category to better align with hepatocellular carcinoma risks and simplify treatment decision-making. In contrast, AASLD 2025, EASL 2025, and WHO 2024 retain conventional immunological phase-based classifications for natural history. For treatment indications, all four guidelines advocate broader access to antiviral therapy despite their divergent structural approaches. AASLD suggests shared decision-making, EASL emphasizes individualized risk assessment, and WHO 2024 abandons the phase-based framework for treatment decisions entirely. Understanding these key similarities and differences will help clinicians optimize patient care and inform future efforts toward global harmonization in CHB management.<\/jats:p>","DOI":"10.3350\/cmh.2026.0697","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:03:38Z","timestamp":1782709418000},"page":"1186-1200","update-policy":"https:\/\/doi.org\/10.3350\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of clinical practice guidelines for chronic hepatitis B: natural history classification and treatment initiation"],"prefix":"10.3350","volume":"32","author":[{"given":"Gi-Ae","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won-Mook","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwang Hyeon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University College of Medicine, Jeonju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Kanto","sequence":"additional","affiliation":[{"name":"Department of Liver Diseases, The Research Center for Hepatitis and Immunology, National Institute of Global Health and Medicine, Japan Institute for Health Security, Chiba, 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