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Management of chronic hepatitis B infection

Vinay Sundaram1, Kris Kowdley2

  • 1Department of Medicine and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

BMJ (Clinical Research Ed.)
|October 23, 2015
PubMed

Insights

Hepatitis B virus (HBV) infection remains a significant global health concern. New antiviral treatments are needed to achieve sustained viral clearance and eliminate hepatitis B surface antigen (HBsAg).

Area of Science:

  • Hepatology
  • Virology
  • Infectious Diseases

Background:

  • Hepatitis B virus (HBV) infection is a major cause of cirrhosis and hepatocellular carcinoma (HCC) worldwide.
  • Despite vaccination efforts, the disease burden remains high, necessitating effective antiviral therapies.
  • Current treatments reduce liver disease progression but face challenges in optimal timing, modality, and duration.

Purpose of the Study:

  • To review the current landscape of Hepatitis B virus (HBV) treatment options.
  • To discuss the benefits and limitations of existing antiviral drugs, including pegylated interferon and nucleos(t)ide analogs.
  • To highlight the need for novel therapeutic strategies for sustained HBV DNA and HBsAg clearance.

Main Methods:

  • Review of current literature on Hepatitis B virus (HBV) treatments.
  • Analysis of approved antiviral agents: pegylated interferon and nucleos(t)ide analogs.
  • Discussion of treatment monitoring, including hepatitis B surface antigen (HBsAg) levels.

Main Results:

  • Nucleos(t)ide analogs offer good tolerability and viral suppression with low resistance risk.
  • Pegylated interferon provides a finite treatment duration but may require HBsAg monitoring for response prediction.
  • Prolonged oral antiviral therapy is often needed, with common relapse upon discontinuation.

Conclusions:

  • Current antiviral treatments for Hepatitis B virus (HBV) are effective but have limitations.
  • Optimal treatment strategies regarding timing, modality, and duration require further investigation.
  • There is a critical need for new treatments that achieve sustained HBV DNA and HBsAg clearance.

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