The "viral-metabolic" interaction mechanisms and management challenges in chronic hepatitis B combined with metabolic dysfunction-associated fatty liver disease: from clinical evidence to an integrated multidisciplinary framework.

The comorbidity of chronic hepatitis B and metabolic dysfunction-associated fatty liver disease involves a bidirectional "virus-metabolism" interaction mechanism, presenting a clinical paradox characterized by improved virological markers alongside an increased risk of hepatocellular carcinoma. Therefore, this article aims to systematically review the interaction mechanisms and regulatory factors between the two conditions, and to propose an integrated "virus-metabolism" dual-axis management framework that includes metabolism-stratified antiviral therapy and synchronous metabolic intervention, so as to provide a theoretical basis for stratified management and behavioral intervention of the comorbidity.