Diagnosing and defining MASLD in people living with chronic hepatitis B

Abstract Chronic hepatitis B (CHB) infection and metabolic dysfunction-associated steatotic liver disease (MASLD) are important contributors to the growing worldwide burden of liver disease. There is limited understanding regarding the interaction between CHB and MASLD. This is a consequence of the changing terminology for liver disease, inconsistent application of diagnostic tools, and poor understanding of global populations. In this review, we collate data on the use of diagnostic tests for identifying MASLD and associated liver inflammation or fibrosis in people living with CHB. We advocate for improved consensus on diagnosis, evidence-based monitoring and risk stratification, enhanced access to interventions and reduced health inequity.