Predicting clinical outcomes in chronic Hepatitis B: An individual risk assessment approach

This thesis demonstrates that specific subgroups of CHB patients, including those with HDV coinfection, advanced fibrosis, or metabolic dysfunction, have an increased risk of adverse liver outcomes, whereas others, such as sub-Sahara African patients without advanced fibrosis and low risk scores, may have a low risk and could safely be excluded from routine HCC surveillance. These findings underscore that a uniform, “one-size-fits-all” approach to risk stratification is inefficient. Personalized strategies integrating fibrosis stage, metabolic risk, and validated risk scores such as PAGE-B are better suited to guide surveillance and treatment decisions. Future research should focus on refining predictive models by incorporating metabolic, demographic, and virological markers, and on investigating whether targeted management of metabolic comorbidities can improve long-term outcomes. Together, these efforts will contribute to more precise and individualized care for patients with chronic hepatitis B.