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Achieving chronic hepatitis B functional cure: Factors and potential mechanisms
Jiarui Zheng1, Zilong Wang1, Linxiang Huang1
1Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People's Hospital, Peking University Hepatology Institute, Beijing, China.
Achieving a functional cure for chronic hepatitis B (CHB) involves overcoming complex host and viral factors. This review explores mechanisms influencing HBsAg loss for better treatment strategies.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic hepatitis B (CHB) affects over 254 million globally, with functional cure (HBsAg loss) as the primary treatment goal.
- Current therapies like nucleos(t)ide analogues (NAs) inhibit HBV DNA but struggle with cccDNA, limiting HBsAg clearance.
- Pegylated interferon alpha (PegIFNα) offers durable functional cure but has a relapse rate exceeding 10%.
Purpose of the Study:
- To systematically review factors and mechanisms influencing functional cure in CHB.
- To provide a basis for personalized treatment and outcome prediction.
- To support the development of novel therapeutic strategies for CHB.
Main Methods:
- Systematic literature review.
- Analysis of host, viral, and environmental factors.
- Investigation of immunological responses (B cell and T cell function).
Main Results:
- HBV DNA integration, persistent cccDNA, and impaired immune responses are key barriers to functional cure.
- Functional cure rates vary significantly based on treatment modality and patient-specific factors.
- Understanding these factors is crucial for optimizing current and future CHB therapies.
Conclusions:
- Functional cure for CHB is multifactorial, requiring a comprehensive approach.
- Personalized treatment strategies informed by host, viral, and immunological profiles are essential.
- Further research into novel therapies targeting cccDNA and enhancing immune function is needed for improved HBsAg clearance.
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