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A Competent Hepatocyte Model Examining Hepatitis B Virus Entry through Sodium Taurocholate Cotransporting Polypeptide as a Therapeutic Target
Published on: May 10, 2022
The current status and future directions of hepatitis B antiviral drug discovery
Liudi Tang1, Qiong Zhao2, Shuo Wu2
1a Microbiology and Immunology graduate program , Drexel University College of medicine , Philadelphia , PA , USA.
Introduction:
The current standard care of chronic hepatitis B fails to induce a durable off-drug control of hepatitis B virus (HBV) replication in the majority of treated patients. The primary reasons are its inability to eliminate the covalently closed circular (ccc) DNA, the nuclear form of HBV genome, and restoration of the dysfunctional host antiviral immune response against the virus. Accordingly, discovery and development of therapeutics to completely stop HBV replication, eliminate or functionally inactivate cccDNA as well as activate a functional antiviral immune response against HBV are the primary efforts for finding a cure for chronic hepatitis B. Area covered: Herein, the authors highlight the current efforts of HBV drug discovery and offer their opinions for the future directions of this research. Expert opinion: The authors believe that through a consecutive or overlapping three-stage antiviral and immunotherapy program to: (i) completely stop HBV replication and cccDNA amplification; (ii) reduce viral antigen load and induce HBV surface antigen (HBsAg) seroclearance through eradication or inactivation of cccDNA and RNA interference-mediated degradation of viral mRNA and (iii) activate a functional antiviral immune response against HBV through therapeutic immunization or immunotherapy, a functional cure of chronic HBV infection can be achieved in the majority of chronic HBV carriers.
Insights
Current chronic hepatitis B treatments cannot eliminate the virus. A new three-stage approach aims to stop hepatitis B virus (HBV) replication, clear viral DNA, and boost immune response for a functional cure.
Area of Science:
- Hepatology and Virology
- Immunotherapy
- Drug Discovery
Background:
- Standard chronic hepatitis B care is insufficient for durable viral control.
- Key challenges include eliminating covalently closed circular (ccc) DNA and restoring immune function.
- Novel therapeutics are needed to achieve a functional cure for chronic hepatitis B.
Purpose of the Study:
- To review current hepatitis B virus (HBV) drug discovery efforts.
- To propose future research directions for HBV therapeutics.
- To outline a strategy for achieving a functional cure for chronic hepatitis B.
Main Methods:
- Literature review of HBV drug discovery.
- Expert opinion on therapeutic strategies.
- Proposal of a three-stage antiviral and immunotherapy program.
Main Results:
- Current therapies do not eliminate HBV cccDNA or restore immune responses.
- A multi-stage approach is proposed to address these limitations.
- The proposed program aims for HBV replication arrest, antigen reduction, and immune activation.
Conclusions:
- A functional cure for chronic hepatitis B requires a comprehensive strategy.
- The proposed three-stage program targets viral elimination and immune restoration.
- This approach may lead to durable off-drug control and seroclearance of HBsAg.
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