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Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
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Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the...
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Prospects for Controlling Hepatitis B Globally.

Vicente Soriano1, Víctor Moreno-Torres1,2, Ana Treviño1

  • 1UNIR Health Sciences School & Medical Center, 28010 Madrid, Spain.

Pathogens (Basel, Switzerland)
|April 26, 2024
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Summary

Hepatitis B virus (HBV) infection is a global health crisis. New therapies aim for a functional cure, but lifelong treatment and vaccination are key to eradicating HBV.

Keywords:
bulevirtidechronic hepatitis Bentecavirgene editinghepatitis deltalong-acting antiviralstenofovir

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Area of Science:

  • Hepatology and Virology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis B virus (HBV) infection affects over 250 million globally, causing significant mortality from liver cancer.
  • Despite available vaccines, global coverage is suboptimal, with 1.5 million new infections annually, primarily through sexual transmission in adults.
  • Current oral nucleos(t)ide analogues achieve viral suppression but rarely a functional cure, necessitating lifelong treatment.

Purpose of the Study:

  • To review the current landscape of hepatitis B virus (HBV) management and explore emerging therapeutic strategies.
  • To highlight the limitations of existing treatments and the need for novel approaches to achieve a functional cure for chronic HBV.
  • To outline essential public health actions for global HBV eradication.

Main Methods:

  • Review of current antiviral therapies, including oral nucleos(t)ide analogues (entecavir, tenofovir).
  • Discussion of novel therapeutic agents in development (entry inhibitors, capsid assembly modulators, RNA interference).
  • Exploration of advanced strategies like combination therapy, gene editing, and gene therapy for HBV genome disruption.

Main Results:

  • Nucleos(t)ide analogue therapy leads to undetectable viremia in most adherent patients but rarely achieves anti-HBs seroconversion or a cure.
  • Emerging therapies and combination strategies aim for a functional cure (negative HBV-DNA and HBsAg), though the cccDNA reservoir persists.
  • Gene therapies offer potential for definitive HBV genome disruption and a complete cure.

Conclusions:

  • Lifelong antiviral therapy is currently required, but new long-acting formulations and novel agents promise improved outcomes.
  • Achieving a functional cure remains a goal, with gene therapies showing promise for ultimate eradication.
  • Expanding newborn vaccination, adult screening, and earlier antiviral treatment are critical for global HBV control and elimination.