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Current state-of-the-art pharmacotherapy for the management of hepatitis B infection
Hans L Tillmann1,2, Gbeminiyi Samuel1
1a Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Brody School of Medicine , East Carolina University , Greenville , NC , USA.
Insights
Hepatitis B virus (HBV) infection requires ongoing management, but new strategies may allow for shorter treatment durations. Targeting Hepatitis D Virus (HDV) could offer a functional cure for HBV.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) infection affects hundreds of millions globally, necessitating effective management to prevent severe outcomes.
- Current HBV treatments often require lifelong therapy, unlike the defined treatment periods for Hepatitis C Virus (HCV).
Purpose of the Study:
- To review current state-of-the-art therapies for HBV.
- To explore potential variations from current treatment guidelines.
- To identify patient groups who may benefit from specific therapeutic approaches.
Main Methods:
- Literature review of current HBV treatment strategies.
- Analysis of patient eligibility for alternative or suboptimal therapies.
- Evaluation of interferon therapy's sustained response potential.
Main Results:
- Some patients with low baseline viral load may be suitable for less intensive therapies.
- Identifying ideal candidates for interferon therapy can lead to good sustained responses.
- Linking patients to care remains a significant challenge in managing HBV.
Conclusions:
- Future HBV therapies should prioritize safety and shorter treatment durations.
- Hepatitis D Virus (HDV), dependent on HBV, presents an unmet clinical need and a potential target for a functional cure for hepatitis B.
Introduction:
Hepatitis B virus (HBV) infection remains a global challenge with several hundred million infected individuals. Disease activity can be controlled, and adverse outcomes prevented when treatment can be provided. Frequently life-long therapy is required instead of defined treatment periods such as with the case of Hepatitis C Virus (HCV) infection.
Areas Covered:
In this review, the authors provide an overview of current start of the art therapy for HBV and indicate where variation from the current guidelines could be considered. Certain patients may be eligible for treatment with suboptimal therapies when their baseline viral load is low. Identifying ideal candidates for interferon therapy will result in good sustained responses for some patients.
Expert Opinion:
The biggest challenge remains linking patients to care and therapy. Patients can nowadays be sufficiently treated before the disease advances to a more progressed phase. However, future therapies must be extremely safe and ideally limit the required treatment period. Given Hepatitis D Virus's dependence on HBV and being a disease with an unmet clinical need, HDV may be the best target group for the development of a functional cure for hepatitis B.
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