In this educational video, Christopher Bowlus, MD, the Chief of Gastroenterology at the University of California Davis and Lena Valente Professor, provides a comprehensive overview of current pharmacologic and non-pharmacologic strategies for managing pruritus (itch) in patients with Primary Biliary Cholangitis (PBC). He explains why pruritus is one of the most common and under recognized symptoms of PBC, affecting up to 80% of patients, and highlights the importance of proactively asking patients about itch using validated tools such as the Numeric Rating Scale (NRS). The discussion explores how itch impacts quality of life, sleep, and social functioning, and reviews practical assessment strategies in clinical practice. Dr. Bowlus walks through conservative measures, historical therapies such as bile acid sequestrants and antihistamines, and their limitations, before focusing on emerging evidence-based treatments that target the underlying cholestatic mechanisms of itch. He reviews the role of PPAR agonists, including newer agents studied in phase 3 trials, as well as intestinal bile acid transport (IBAT) inhibitors that may soon expand available treatment options. The video concludes with a practical framework for individualized symptom management, emphasizing that effective control of pruritus can meaningfully improve patient outcomes and overall quality of life in PBC.

In this video, Aparna Goel, MD, associate professor of medicine at Stanford University, reviews the impact of pregnancy on primary biliary cholangitis (PBC) and key considerations for managing pregnant patients with autoimmune liver disease. The discussion covers how pregnancy affects PBC laboratory markers, including the limitations of alkaline phosphatase as a biomarker, common symptom changes such as worsening pruritus, and the importance of monitoring bile acids, liver enzymes, and fat-soluble vitamins. Medication safety during pregnancy, including continued use of ursodeoxycholic acid, maternal and fetal risk assessment, monitoring for portal hypertension, and postpartum follow-up are also addressed. This practical overview highlights multidisciplinary care and real-world strategies to support safe maternal and fetal outcomes in women with PBC during pregnancy.

In this overview, Tatyana Kushner, MD, reviews key aspects of hepatitis B pathophysiology with a focus on covalently closed circular DNA (cccDNA) and its role in viral persistence and barriers to cure. She explains how cccDNA is established and maintained within hepatocytes, how host epigenetic regulation influences viral transcription, and why current antiviral therapies are unable to eliminate cccDNA. The discussion highlights emerging cure strategies, including epigenetic silencing, direct cccDNA targeting, gene-editing technologies, and host factor modulation. Dr. Kushner also explores immune-viral interactions in chronic hepatitis B, including immune exhaustion and checkpoint pathways, as well as clinically relevant extrahepatic manifestations and diagnostic considerations. The video concludes with an overview of hepatitis B genotypes and their impact on disease progression, hepatocellular carcinoma risk, and therapeutic response.

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.