Abstract
Hepatitis B virus (HBV) remains a significant global health problem, particularly in India, where its prevalence is gradually decreasing, both in the general population and among healthcare workers. The management of HBV treatment should be individualized based on key factors such as HBV DNA levels, alanine transaminase (ALT) levels, and the presence of comorbid conditions like diabetes mellitus (DM), metabolic dysfunction associated steatotic liver disease (MASLD), pregnancy, cirrhosis, and decompensated cirrhosis. The "treat for all" strategy, although debated, was partially endorsed by the Indian National Association for the Study of the Liver (INASL). Pegylated interferon (Peg IFN) was not widely recommended due to limited practice, and genotype testing was avoided. Hepatitis D was not considered a prevalent condition; thus, testing for it was not emphasized. Special conditions, including immunosuppression and steroid therapy, were also discussed, and INASL provided comprehensive guidelines to address these unique scenarios in HBV management. High-resistance-barrier drugs like tenofovir alafenamide (TAF) were highlighted for their effectiveness and safety, particularly in pregnant women. Vaccination was strongly recommended for special risk groups, including healthcare workers and high-risk populations, while the debate on universal screening and vaccination continues, weighing its potential benefits against logistical challenges.