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Roadmap to functional cure of chronic hepatitis B: An expert consensus

Qin Ning1, Di Wu1, Gui-Qiang Wang2

  • 1Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Journal of Viral Hepatitis
|May 16, 2019
PubMed

Insights

Achieving a functional cure for chronic hepatitis B involves HBsAg loss. Combination therapy with nucleos(t)ide analogues and pegylated interferon alpha2a can lead to remission.

Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Chronic hepatitis B virus (HBV) infection remains a significant global health concern.
  • Hepatitis B surface antigen (HBsAg) loss signifies functional remission and improved long-term outcomes, representing a functional cure for chronic hepatitis B.
  • Current therapeutic strategies aim for this functional cure, defined as clinical or immunological remission.

Purpose of the Study:

  • To provide an updated review of evidence supporting combination therapies for chronic hepatitis B.
  • To summarize expert consensus on strategies for achieving a functional cure in patients with chronic hepatitis B.
  • To highlight the role of direct-acting antivirals and immunomodulators in achieving HBsAg loss.

Main Methods:

  • Review of current scientific literature on HBV combination therapies.
  • Analysis of clinical trial data on nucleos(t)ide analogues (NAs) and pegylated interferon alpha2a (Peg-IFN).
  • Synthesis of expert opinions and consensus guidelines regarding functional cure strategies.

Main Results:

  • Optimized combination regimens, particularly NA lead-in followed by Peg-IFN in virally suppressed patients, demonstrate effectiveness.
  • HBsAg loss is achievable and associated with favorable long-term prognosis.
  • Combination therapies offer a viable pathway towards functional cure for selected chronic hepatitis B patients.

Conclusions:

  • Combination therapy with NAs and Peg-IFN is a promising strategy for achieving functional cure in chronic hepatitis B.
  • Achieving HBsAg loss through optimized treatment regimens is a key goal for managing chronic HBV infection.
  • Further research and expert consensus are crucial for refining the roadmap to functional cure.

Keywords:
HBsAg losschronic hepatitis Bcombination therapyconsensusfunctional cure

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