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New therapies for chronic hepatitis B
Author(s) -
Bitton Alaluf Maya,
Shlomai Amir
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13086
Subject(s) - hepatocellular carcinoma , medicine , hepatitis b virus , cirrhosis , hepatitis b , virus , chronic infection , virology , immunology , interferon , antiviral drug , immune system
Approximately 350 million people worldwide are chronically infected with hepatitis B virus ( HBV ), representing a significant public health challenge. Nucleos/tide analogues ( NUC s) and interferon alpha ( IFN α), the current standard of care for chronic infection, aim at preventing progression of the disease to cirrhosis, hepatocellular carcinoma ( HCC ) and death. However, in contrast to the case of hepatitis C virus infection, in which novel antiviral drugs cure the vast majority of treated patients, in regard to HBV , cure is rare due to the unusual persistence of viral DNA in the form of covalently closed circular DNA (ccc DNA ) within the nucleus of infected cells. Available therapies for HBV require lifelong treatment and surveillance, as reactivation frequently occurs following medication cessation and the occurrence of HCC is decreased but not eliminated, even after years of successful viral suppression. Progress has been made in the development of new therapeutics, and it is likely that only a combination of immune modulators, inhibitors of gene expression and replication and ccc DNA ‐targeting drugs will eradicate chronic infection. This review aims to summarize the state of the art in HBV drug research highlighting those agents with the greatest potential for success based on in vitro as well as on data from clinical studies.