Is HBV Really a Silent Disease? New Patient-Reported Data Suggests Otherwise

Most people living with hepatitis B who were taking antiviral therapy reported high adherence, while nearly two-thirds of those not on treatment were receiving no hepatitis B care at all, according to multinational survey data presented by Chari Cohen at The Liver Meeting 2026 in Denver, Colorado.

“It is not silent for the people who have it,” Cohen, president of the Hepatitis B Foundation, told HCPLive, describing the physical and emotional toll the disease takes even in the absence of liver damage.

What Did the Survey Reveal?

The ongoing longitudinal study surveyed 486 adults living with hepatitis B in 42 countries. Among the 50.9% taking antivirals, 86.2% reported taking medication daily as directed, and 84.4% were confident treatment was helping. Fatigue or weakness was the most commonly reported symptom (44.0%), and more than half of participants were highly concerned about liver-related illness and death. About 1 in 4 participants rated their relationship with their physician as fair or poor.¹

Among participants not taking antivirals, 63.7% were not engaged in any hepatitis B care, most often citing cost, limited access to clinicians or medication, or feeling healthy. Yet 73.5% said they would be very willing to start therapy if recommended.¹

Why Does the Treatment Gap Matter?

Of the estimated 254 million people living with chronic hepatitis B worldwide in 2022, only 13% had been diagnosed and about 3% had received antiviral therapy.² Cohen says closing that gap will require governments to prioritize hepatitis B elimination, as many did for hepatitis C. She also hopes follow-up data will help turn adherence from a reason to delay treatment into something clinicians can actively support.

Watch the full interview to hear Cohen discuss why patient-reported outcomes have long been missing from hepatitis B care, what later time points may show, and how shared decision-making can be put into practice.

References

1. Ibrahim Y, Freeland C, Cohen C. Hepatitis B patient-reported outcomes: multinational insights on quality of life and antiviral adherence. Presented at: The Liver Meeting 2026; November 5-9, 2026; Denver, CO.
2. World Health Organization. Global Hepatitis Report 2024: Action for Access in Low- and Middle-Income Countries. World Health Organization; 2024. Accessed November 11, 2026. https://www.who.int/publications/i/item/9789240091672