Liver sampling: a vital window into HBV pathogenesis on the path to functional cure

Area of Science:

• Hepatology
• Immunology
• Virology

Background:

• Liver biopsy traditionally assessed hepatitis B virus (HBV) disease, but non-invasive markers are shifting focus away from tissue sampling.
• Emerging research highlights specialized tissue-resident immune subsets within the liver crucial for pathogen surveillance, not detectable in blood.

Purpose of the Study:

• To re-emphasize the indispensable role of liver biopsy in the clinical assessment and research of HBV.
• To advocate for the continued importance of liver tissue and aspirates in evaluating novel therapeutic agents for HBV functional cure.

Main Methods:

• Discussion of strategies to maximize information retrieval from liver tissue and fine needle aspirates.
• Integration of liver sampling data with blood analysis for comprehensive virological and immunological assessment.

Main Results:

• Liver biopsy provides essential data on virological parameters like cccDNA quantitation.
• Tissue-resident immune cells in the liver offer unique insights into HBV-specific immune surveillance.
• Fine needle aspirates enable longitudinal monitoring of the local virus-host dynamics.

Conclusions:

• Liver biopsy remains a critical tool for HBV clinical assessment and research, despite the rise of non-invasive methods.
• Optimal evaluation of novel HBV therapeutics requires integrated analysis of liver tissue, aspirates, and blood samples.
• Longitudinal sampling via fine needle aspirates can enhance understanding of the local virus-host landscape for functional cure strategies.