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Microorganisms play a fundamental role in vaccine development, gene therapy, and therapeutic production. Their biological properties are harnessed to advance medicine and public health. Beyond immunization, microorganisms contribute to gut health, antibiotic synthesis, and genetic disease treatment.Live Attenuated and Inactivated VaccinesLive attenuated vaccines, such as the measles, mumps, and rubella (MMR) vaccine, utilize weakened forms of pathogens to closely resemble natural infections.
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Getting to HBV cure: The promising paths forward.

Scott Fung1, Hannah S J Choi1, Adam Gehring1

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Achieving a cure for chronic hepatitis B (CHB) requires overcoming viral persistence and immune dysfunction. Future therapies may involve triple combinations targeting viral replication, antigen reduction, and immune stimulation for a functional cure.

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Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Chronic hepatitis B virus (HBV) infection affects nearly 300 million globally, posing a significant public health challenge.
  • Current antiviral therapies suppress HBV replication but do not achieve a cure due to persistent viral forms (cccDNA, integrated DNA) and immune impairment.

Purpose of the Study:

  • To review current therapies for chronic hepatitis B (CHB).
  • To discuss HBV biomarkers for treatment response evaluation.
  • To explore the development of direct-acting antivirals (DAAs) and immunomodulatory drugs for an HBV cure.

Main Methods:

  • Literature review of current and emerging therapies for CHB.
  • Analysis of HBV biomarkers and their role in assessing treatment efficacy.
  • Examination of clinical development pathways for DAAs and immunomodulators.

Main Results:

  • DAAs targeting various stages of the HBV lifecycle are in clinical development.
  • Immunomodulators, including TLR agonists and checkpoint inhibitors, are also progressing.
  • Triple combination therapies are proposed as a future strategy for HBV cure.

Conclusions:

  • An HBV cure likely necessitates a combination approach including replication inhibition, antigen reduction, and immune stimulation.
  • Significant obstacles remain, including translational failures and defining optimal endpoints and biomarkers.
  • Further research is needed to overcome limitations and advance towards a functional cure for CHB.