{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:00:57Z","timestamp":1784818857063,"version":"3.55.0"},"reference-count":86,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Over 257 million individuals worldwide are chronically infected with the Hepatitis B Virus (HBV). Nucleos(t)ide analogues (NAs) are the first-line treatment option for most patients. Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are both potent, safe antiviral agents, have a high barrier to resistance, and are now off patent. They effectively suppress HBV replication to reduce the risk of cirrhosis, liver failure, and hepatocellular carcinoma (HCC). Treatment is continued long-term in most patients, as NA therapy rarely induces HBsAg loss or functional cure. Two diverging paradigms in the treatment of chronic hepatitis B have recently emerged. First, the public health focussed \u201ctreat-all\u201d strategy, advocating for early and lifelong antiviral therapy to minimise the risk of HCC as well as the risk of HBV transmission. In LMICs, this strategy may be cost saving compared to monitoring off treatment. Second, the concept of \u201cstopping\u201d NA therapy in patients with HBeAg-negative disease after long-term viral suppression, a personalised treatment strategy aiming for long-term immune control and even HBsAg loss off treatment. In this manuscript, we will briefly review the current standard of care approach to the management of hepatitis B, before discussing emerging evidence to support both the \u201ctreat-all\u201d strategy, as well as the \u201cstop\u201d strategy, and how they may both have a role in the management of patients with chronic hepatitis B.<\/jats:p>","DOI":"10.3390\/v12090934","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T09:24:56Z","timestamp":1598347496000},"page":"934","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Yin and the Yang of Treatment for Chronic Hepatitis B\u2014When to Start, When to Stop Nucleos(t)ide Analogue Therapy"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7158-585X","authenticated-orcid":false,"given":"Samuel","family":"Hall","sequence":"first","affiliation":[{"name":"Gastroenterology Department, St Vincent\u2019s Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC 3065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Howell","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, St Vincent\u2019s Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC 3065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-5442","authenticated-orcid":false,"given":"Kumar","family":"Visvanathan","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, St Vincent\u2019s Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC 3065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Thompson","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, St Vincent\u2019s Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC 3065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"ref_1","unstructured":"Australian Government Department of Health (2020, July 01). 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