In this episode, Dr. Robert Wong from Stanford University School of Medicine discusses the importance of patient-centered care and the role of patient-reported outcomes in the comprehensive management of chronic hepatitis B. Dr. Wong explains how PROs capture patients’ perspectives on their physical, mental, and social well-being—critical yet often underrecognized components of care. He highlights three validated tools that can be easily integrated into clinical practice: the Short Form-36 (SF-36), the Chronic Liver Disease Questionnaire (CLDQ), and the Work Productivity and Activity Impairment (WPAI) Instrument. These measures help clinicians better understand how hepatitis B impacts patients’ daily lives, guide individualized treatment decisions, and strengthen multidisciplinary care involving hepatologists, mental health professionals, nutritionists, and other specialists. By incorporating PROs into pre-visit checklists and ongoing follow-up, providers can identify barriers to treatment, improve communication, and deliver more meaningful, patient-centered outcomes.

In this episode, Dr. Robert Wong from the Division of Gastroenterology and Hepatology at Stanford University School of Medicine discusses the value of patient-centric care and patient-reported outcomes in managing Primary Biliary Cholangitis (PBC). While traditional care often focuses on liver function tests and biochemical markers like alkaline phosphatase, Dr. Wong emphasizes the equal importance of understanding how PBC impacts a patient’s daily life, mental health, and overall quality of life. He highlights the PBC-40 questionnaire, a validated tool that captures six key domains—fatigue, emotional well-being, social and cognitive function, general symptoms, and itch (pruritus)—making it an essential instrument for comprehensive symptom assessment. Incorporating the PBC-40 into pre-visit questionnaires or waiting-room checklists allows clinicians to efficiently identify and address the most distressing symptoms before and during patient visits. Dr. Wong explains how integrating PROs enhances shared decision-making, helps manage challenging symptoms such as pruritus, and fosters multidisciplinary collaboration with specialists in dermatology, mental health, nutrition, and rheumatology. This holistic, patient-centered approach not only improves symptom management but also strengthens engagement, satisfaction, and outcomes for individuals living with PBC.

In this expert discussion, Dr. Paul Kwo, hepatologist at Stanford University, explores the critical importance of patient adherence to treatment for chronic hepatitis B. Hepatitis B remains a global public health challenge and a leading cause of liver cancer—and yet in the U.S., many individuals remain undiagnosed or untreated. Dr. Kwo outlines how to assess disease stage, when to initiate antiviral therapy, and how to communicate effectively with patients—especially foreign-born individuals—about the safety, effectiveness, and accessibility of approved treatments. He explains how these once-daily therapies improve outcomes, reduce the risk of liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC), and why long-term follow-up is essential even for those not immediately eligible for treatment. Dr. Kwo also addresses cultural considerations, cost concerns, and common misconceptions around alternative therapies. This presentation emphasizes that hepatitis B is not only manageable—it is a condition where proactive care leads to meaningful, life-extending results.

Join Dr. Ira Jacobson, Professor of Medicine at NYU Langone Health, for an in-depth exploration of the complex pathophysiology of chronic hepatitis B. In this expert lecture, Dr. Jacobson reviews the virologic and immunologic mechanisms that underpin HBV infection, from viral entry into hepatocytes and the formation of covalently closed circular DNA (cccDNA), to the integration of viral DNA and its implications for hepatocellular carcinoma. He also examines the immune system’s multifaceted role in disease progression, including T-cell exhaustion, checkpoint inhibition, and the contributions of humoral immunity. The discussion extends to cutting-edge therapeutic strategies aimed at achieving functional cure, including siRNAs, antisense oligonucleotides, therapeutic vaccines, monoclonal antibodies, and T-cell receptor therapies. Whether you're a hepatology provider, researcher, or student, this comprehensive overview sheds light on where we are in the fight against HBV—and where promising advances may take us next.

In this expert video, Dr. Robert Gish—renowned hepatologist and Medical Director of the Hepatitis B Foundation—discusses the critical role of quantitative hepatitis B surface antigen (HBsAg) testing in the management and long-term monitoring of chronic hepatitis B. With over a decade of experience using quantitative HBsAg in clinical practice, Dr. Gish explains how this highly sensitive test complements HBV DNA and e-antigen testing to assess disease phase, track treatment response, and evaluate a patient's candidacy for functional cure. He breaks down how low surface antigen levels can signal improved outcomes, including reduced liver cancer risk and lower infectivity, and how this data supports decision-making around nucleos(t)ide analogue (NUC) therapy continuation or cessation. Dr. Gish also discusses emerging therapies, including interferon combinations, antisense oligonucleotides (ASOs), capsid assembly modulators (CPAMs), and therapeutic vaccines—highlighting the future potential of viral silencing strategies aimed at complete hepatitis B control. For clinicians and researchers, this session underscores why quantitative HBsAg is a foundational biomarker for baseline assessment, longitudinal follow-up, and treatment strategy optimization in chronic HBV.

In this expert highlight, Dr. Robert Wong shares essential tips for monitoring and managing patients with Primary Biliary Cholangitis (PBC). He outlines key goals after diagnosis, including evaluating liver disease severity through imaging and lab-based non-invasive testing, and assessing treatment eligibility. Dr. Wong explains the importance of monitoring alkaline phosphatase (ALP) levels—not only to guide treatment initiation but also to measure treatment response, with normalization signaling a complete response. Beyond labs, he emphasizes the need to assess patient-reported outcomes such as fatigue and pruritus, which directly impact quality of life. He also discusses the challenges of interpreting non-invasive fibrosis tools in PBC, highlighting the importance of longitudinal monitoring to track disease direction over time. Finally, Dr. Wong stresses patient engagement—using consistent follow-up, clear education, and linking lab results with symptom improvements to keep patients motivated in their care journey. This practical overview offers valuable insights for clinicians and patients aiming to optimize outcomes in PBC management.

Join Dr. Alan Bonder, Associate Professor of Medicine at Harvard Medical School and Medical Director of Liver Transplantation, for an expert overview on the latest AASLD guideline updates for Primary Biliary Cholangitis (PBC). This in-depth session highlights key diagnostic criteria—such as AMA positivity, elevated alkaline phosphatase, and histologic confirmation—and walks through evidence-based treatment pathways for managing PBC. Dr. Bonder discusses the pivotal role of ursodeoxycholic acid (UDCA) as first-line therapy and emphasizes the importance of risk stratification using tools like FibroScan and biochemical markers to identify non-responders.

He outlines thresholds for therapeutic response and reviews the FDA-approved second-line therapies, including obeticholic acid and the three new agents approved in summer 2024, while addressing safety concerns and boxed warnings. Dr. Bonder also underscores the need to address quality of life, managing symptoms like fatigue, pruritus, and abdominal pain—often overlooked but impactful for patients with PBC. With clinical pearls on when to escalate care or refer for liver transplantation, this session offers a comprehensive, practical roadmap for optimizing PBC outcomes today and in the future.

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In this practical and patient-focused video, Dr. Nadege Gunn, a hepatologist based in Waco, Texas, shares essential diet and lifestyle strategies for individuals living with Primary Biliary Cholangitis (PBC). Addressing a common question—“What can I eat or do to feel better?”—Dr. Gunn highlights the benefits of a balanced, Mediterranean-style diet rich in fruits, vegetables, nuts, seeds, fish, and olive oil. She emphasizes bone health as a key concern for PBC patients, recommending adequate intake of vitamin D and calcium, resistance-based exercises, and regular weight-bearing activity. The video also stresses the importance of monitoring fat-soluble vitamin levels (A, D, E, and K), avoiding alcohol, and supplementing with a multivitamin if needed. Dr. Gunn further underscores the role of maintaining a healthy weight, staying active, avoiding smoking, and ensuring hepatitis A and B vaccinations to prevent additional liver complications. Whether you're a provider looking to guide patients or someone living with PBC seeking actionable advice, this video offers valuable lifestyle recommendations to help manage the disease and improve overall liver health.

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In this thoughtful discussion, Dr. Nancy Reau from RUSH University Medical Center explores the often-overlooked psychological impact of Primary Biliary Cholangitis (PBC). While managing the physical symptoms of PBC is critical, addressing the emotional and mental health challenges faced by patients is equally important. Dr. Reau highlights how the lifelong nature of PBC, its familial implications, unpredictable progression, and extrahepatic symptoms like fatigue and pruritus can contribute to significant stress, anxiety, and emotional strain. Many patients may appear physically healthy yet suffer from symptoms that disrupt their daily lives and relationships—leading to frustration, isolation, and misunderstood expectations from others. Even those in biochemical remission can experience mental health burdens, especially if they’ve seen loved ones struggle with the disease. Dr. Reau emphasizes the need for providers to initiate open conversations about these psychological effects to validate patient experiences and support overall wellness. If you're a clinician or caregiver seeking a more holistic approach to PBC management, or a patient navigating the emotional side of liver disease, this video offers compassionate, practical guidance.

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In this insightful discussion, Dr. Tatyana Kushner, hepatologist and associate professor at Weill Cornell Medicine, explores the critical issue of medication adherence in patients living with Primary Biliary Cholangitis (PBC). While ursodeoxycholic acid (ursodiol) remains the cornerstone of first-line therapy for PBC, up to half of patients express uncertainty or reluctance about taking it consistently. Dr. Kushner delves into the complex barriers affecting adherence, including lack of symptom relief, fear of side effects, misunderstanding of long-term benefits, pill burden from multiple daily doses, and socioeconomic challenges such as medication costs and insurance coverage. She also addresses the impact of extrahepatic symptoms—like pruritus, fatigue, and depression—which can further discourage regular medication use. Importantly, certain subgroups, such as younger patients and males, have been shown to be at higher risk for non-adherence and may require additional support. If you're a healthcare provider managing PBC or a patient navigating treatment, this video offers valuable insights into improving adherence and outcomes.