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Current Best Practice in Hepatitis B Management and Understanding Long-term Prospects for Cure.

Authors :
Yardeni D
Chang KM
Ghany MG
Source :
Gastroenterology [Gastroenterology] 2023 Jan; Vol. 164 (1), pp. 42-60.e6. Date of Electronic Publication: 2022 Oct 12.
Publication Year :
2023

Abstract

The hepatitis B virus (HBV) is a major cause of cirrhosis and hepatocellular carcinoma worldwide. Despite an effective vaccine, the prevalence of chronic infection remains high. Current therapy is effective at achieving on-treatment, but not off-treatment, viral suppression. Loss of hepatitis B surface antigen, the best surrogate marker of off-treatment viral suppression, is associated with improved clinical outcomes. Unfortunately, this end point is rarely achieved with current therapy because of their lack of effect on covalently closed circular DNA, the template of viral transcription and genome replication. Major advancements in our understanding of HBV virology along with better understanding of immunopathogenesis have led to the development of a multitude of novel therapeutic approaches with the prospect of achieving functional cure (hepatitis B surface antigen loss) and perhaps complete cure (clearance of covalently closed circular DNA and integrated HBV DNA). This review will cover current best practice for managing chronic HBV infection and emerging novel therapies for HBV infection and their prospect for cure.<br /> (Published by Elsevier Inc.)

Details

Language :
English
ISSN :
1528-0012
Volume :
164
Issue :
1
Database :
MEDLINE
Journal :
Gastroenterology
Publication Type :
Academic Journal
Accession number :
36243037
Full Text :
https://doi.org/10.1053/j.gastro.2022.10.008