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[Hepatitis C can be cured: will hepatitis B become next?]
V P Chulanov1, A P Zueva2, D S Kostyushev3
1Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russian Federation, Moscow, Russia.
Terapevticheskii Arkhiv
|December 21, 2017
Summary
New therapies offer hope for chronic hepatitis B (CHB) and C (CHC) patients, with genome editing technologies like CRISPR/Cas showing promise for complete viral elimination, though still in early development.
Area of Science:
- Hepatology
- Virology
- Molecular Biology
Background:
- Chronic hepatitis B (CHB) and C (CHC) cause significant global mortality from cirrhosis and liver cancer.
- While CHC is curable, CHB management involves viral suppression with frequent relapses upon treatment cessation.
- Complete elimination of hepatitis B virus (HBV) is hindered by persistent, antiviral-resistant covalently closed circular DNA (cccDNA) in hepatocytes.
Purpose of the Study:
- To review current therapeutic strategies for CHB and CHC.
- To explore novel treatment modalities targeting different stages of the HBV life cycle.
- To assess the potential of emerging technologies, particularly genome editing, for achieving a functional or complete cure for CHB.
Main Methods:
- Review of recent advancements in antiviral therapeutics for CHC and CHB.
- Analysis of novel drug development targeting HBV entry, cccDNA, and viral assembly.
- Evaluation of immunotherapeutic approaches to enhance host responses.
- Assessment of genome editing technologies (TALENs, CRISPR/Cas) and RNA interference for HBV clearance.
Main Results:
- Hepatitis C is now curable with modern antivirals.
- Current CHB therapies suppress HBV replication but do not achieve a complete cure, with functional cure (HBsAg loss) being rare.
- Emerging therapies, including cccDNA inhibitors, genome editing, and immune modulators, show promise in experimental settings.
- Genome editing technologies, such as CRISPR/Cas, demonstrate potential for specific cccDNA degradation, offering a pathway to complete HBV elimination.
Conclusions:
- While significant progress has been made, particularly in CHC treatment, CHB remains a challenging disease requiring innovative therapeutic approaches.
- Novel direct-acting antivirals and immunotherapies are advancing CHB treatment, with potential for functional cure.
- Genome editing technologies represent a highly promising future strategy for achieving complete HBV eradication by targeting the persistent cccDNA reservoir, despite being in early developmental stages.
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