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Impact of therapy on the outcome of chronic hepatitis B

Yun-Fan Liaw1

  • 1Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan. liveryfl@gmail.com

Liver International : Official Journal of the International Association for the Study of the Liver
|January 5, 2013
PubMed

Insights

Chronic hepatitis B virus (HBV) infection requires effective therapies to suppress viral replication and prevent liver disease progression. While current treatments like nucleos(t)ide analogues and interferon show promise, improved agents are needed for better patient outcomes.

Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Chronic hepatitis B virus (HBV) infection drives liver disease progression, including cirrhosis and hepatocellular carcinoma (HCC).
  • HBV replication is the primary factor influencing disease advancement.
  • Current therapeutic aims focus on HBV suppression to mitigate liver damage and reduce associated risks.

Purpose of the Study:

  • To review the efficacy of current anti-HBV therapies, including nucleos(t)ide analogues (Nuc) and interferon (IFN).
  • To discuss the potential for sustained viral response and hepatitis B surface antigen (HBsAg) seroclearance.
  • To highlight the need for developing more effective and affordable anti-HBV strategies.

Main Methods:

  • Review of existing literature on HBV treatment outcomes.
  • Analysis of therapeutic effects of nucleos(t)ide analogues and interferon therapies.
  • Evaluation of factors influencing long-term benefits and treatment resistance.

Main Results:

  • Nucleos(t)ide analogues (Nuc) rapidly suppress HBV replication, normalize transaminases, and improve survival in decompensated patients.
  • Interferon (IFN) therapy offers sustained response, reduces fibrosis progression, and lowers risks of cirrhosis and HCC.
  • Hepatitis B surface antigen (HBsAg) seroclearance, a near-cure state, is achievable with sustained viral response, particularly with IFN-based treatments.
  • Pegylated IFN (PEG-IFN) and newer Nucs show potential for improved outcomes due to enhanced efficacy and lower resistance rates.

Conclusions:

  • Current therapies like Nuc and IFN can significantly improve outcomes in chronic HBV infection by suppressing viral replication and improving liver histology.
  • HBsAg seroclearance represents a key goal, achievable in some patients with sustained viral response.
  • Despite advancements, treatment outcomes remain suboptimal, necessitating the development of novel, effective, safe, and affordable anti-HBV agents and strategies.

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