Premium
Immune balance in Hepatitis B Infection: Present and Future Therapies
Author(s) -
Vyas A. K.,
Jindal A.,
Hissar S.,
Ramakrishna G.,
Trehanpati N.
Publication year - 2017
Publication title -
scandinavian journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.934
H-Index - 88
eISSN - 1365-3083
pISSN - 0300-9475
DOI - 10.1111/sji.12553
Subject(s) - cccdna , immunology , immune system , hbsag , medicine , hepatitis b virus , virology , hepatitis b , viral replication , chronic infection , viral load , nucleoside analogue , virus , biology , nucleoside , biochemistry
Abstract Chronic hepatitis B virus ( HBV ) infection affects millions of people worldwide and about half a million people die every year. India represents the second largest pool of chronic HBV infections with an estimated 40 million chronically infected patients. Persistence or clearance of HBV infection mainly depends upon host immune responses. Chronically infected individuals remain in immune tolerant phase unless HBV flares and leads to the development of chronic active hepatitis or acute‐on‐chronic liver failure. Strategies based on inhibition of viral replication (nucleoside analogues) or immune modulation (interferons) as monotherapy, or in combination in sequential therapies, are currently being used globally for reducing HBV viral load and mediating HB sAg clearance. However, the immune status and current therapies for promoting sustained virological responses in HBV ‐infected patients remain suboptimal. Elimination of ccc DNA is major challenge for future therapies, and new molecules such as NTCP , Toll‐like receptor ( TLR )7 agonist ( GS 9620) and cyclophilin have emerged as potential targets for preventing HBV entry and replication. Other than these, HBV ccc DNA elimination is the major target for future therapies.