[Current and Future Therapy of Hepatitis B and D]

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Hepatitis B virus (HBV) infection is a major global health concern, causing cirrhosis and liver cancer in approximately 240 million people.
• Chronic HBV infection necessitates antiviral treatment when liver damage or high viral load is present.

Purpose of the Study:

• To review current treatment standards for chronic hepatitis B virus infection.
• To discuss emerging therapeutic strategies and challenges in achieving a functional cure for HBV.
• To address specific considerations for pregnant women, immunocompromised individuals, and co-infections with the delta virus (HDV).

Main Methods:

• Review of current antiviral therapies for chronic HBV, including nucleoside/nucleotide analogues and interferon.
• Discussion of preferred treatment options based on patient comorbidities (renal insufficiency, osteoporosis).
• Consideration of prophylactic and therapeutic strategies for specific populations and co-infections.

Main Results:

• Standard therapies like entecavir and tenofovir alafenamide suppress HBV DNA but rarely achieve HBs antigen loss (functional cure).
• Tenofovir is recommended for pregnant women with high viral loads to prevent neonatal transmission.
• Prophylactic antiviral therapy is crucial for immunocompromised patients to prevent HBV reactivation.

Conclusions:

• Current HBV treatments focus on viral suppression, with functional cure remaining a key goal.
• New therapeutic strategies and drugs are under investigation to improve outcomes and achieve sustained viral clearance.
• Management of HBV requires tailored approaches, especially in high-risk groups and co-infections like HDV.