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Upcoming pharmacological developments in chronic hepatitis B: can we glimpse a cure on the horizon?

Sonia Alonso1, Adriana-René Guerra1, Lourdes Carreira1

  • 1Unit of Gastroenterology, Hospital Universitario Fundación Alcorcón, Av. Budapest-1, 28922, Alcorcon, Madrid, Spain.

BMC Gastroenterology
|December 23, 2017
PubMed

Insights

New Hepatitis B virus (HBV) therapies aim to eliminate cccDNA and HBsAg, offering hope beyond lifelong nucleos(t)ide analogue treatment. These novel approaches target various stages of the HBV life cycle for potential viral eradication.

Area of Science:

  • Hepatology and Virology
  • Infectious Diseases
  • Drug Development

Background:

  • Chronic Hepatitis B virus (HBV) infection impacts 240 million globally, leading to cirrhosis and hepatocellular carcinoma (HCC).
  • HBV covalently closed circular DNA (cccDNA) is crucial for viral persistence and replication.
  • Current nucleos(t)ide analogue (NA) treatments suppress HBV but do not eliminate cccDNA, necessitating lifelong therapy.

Purpose of the Study:

  • To review emerging pharmacological developments targeting the HBV life cycle.
  • To assess the efficacy and safety of novel HBV antiviral strategies.
  • To provide an updated perspective on current and future chronic hepatitis B therapeutics.

Main Methods:

  • Comprehensive literature search of PubMed/MEDLINE, AMED, CINAHL, and Cochrane Library (2005-2011).
  • Inclusion of full-text manuscripts and abstracts, with cross-referenced bibliography checks.
  • Focus on pharmacological developments with efficacy and safety data.

Main Results:

  • Reviewed HBV entry inhibitors, core inhibitors, and cccDNA transcript targeting agents (e.g., RNA interference).
  • Examined HBV cell apoptosis inducers, RNA/DNA knockdown agents, and release inhibitors.
  • Assessed anti-sense nucleosides, exogenous interferon, and therapeutic vaccines for HBV.

Conclusions:

  • Emerging therapies show promise for clearing cccDNA and HBsAg, critical for HBV eradication.
  • These novel agents represent a significant advancement over current NA treatments.
  • The review offers insights into the future landscape of chronic hepatitis B treatment.
Abstract

Keywords:
HBV cccDNAHBV eradicationHBV functional cureHepatitis B virus clearanceLatest pharmacological developments

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