Clinical burden, disease progression, and management strategies in chronic hepatitis B: implications for public health practice

Background Chronic hepatitis B (CHB) is one of the most significant global public health issues because it is progressive and has long-term complications, with gaps in real-world management. Longitudinal cohort evidence is required to guide effective disease control strategies. Objective This study aimed to evaluate the clinical burden, disease progression, and management strategies in patients with CHB and to identify factors influencing progression and treatment outcomes in a real-world setting. Methods The study design was a retrospective longitudinal cohort study conducted at a tertiary-care academic referral centre between January 2020 and December 2025. A total of 520 patients were analysed, all of whom were confirmed to have CHB and followed longitudinally through routine clinical care for a mean duration of 4.1 years. Assessment was made on clinical burden, disease progression and management strategies. Kaplan–Meier analyses were used to determine progression-free survival, and mu