Challenges in warranting access to prophylaxis and therapy for hepatitis B virus infection

Recent advances in hepatology

“…Definitely, the future objective of HBV therapy is to have a finite treatment inducing a high rate of HBsAg loss with, if possible, disappearance of cccDNA. The future of HBV therapy will include a combination of more potent immunomodulators and antivirals with different targets (viral entry, protein synthesis, protein‐protein interaction) with strategies that will restore innate and adaptive immune response, completely block HBV replication and eradicate or silence HBV cccDNA . Obviously, to reduce the global health burden of HBV infection, in addition to treatment of chronic carriers, vaccination will need to be scaled‐up to reduce vertical transmission and the number of new cases …”

“…ThefutureofHBVtherapywillincludeacombinationofmorepotent immunomodulators and antivirals with different targets (viral entry, proteinsynthesis,protein-proteininteraction)withstrategiesthatwill restoreinnateandadaptiveimmuneresponse,completelyblockHBV replication and eradicate or silence HBV cccDNA. 11,[21][22][23] Obviously, to reduce the global health burden of HBV infection, in addition to treatmentofchroniccarriers,vaccinationwillneedtobescaled-upto reduceverticaltransmissionandthenumberofnewcases. 23 HDV infects individual HBV carriers since it is necessary for its ownreplication.ChronicHDVinfectionusuallyleadstomoresevere liverdiseasethanHBVmono-infectionandisassociatedwithacceleratedfibrosisprogression,morefrequenthepaticdecompensationand anincreasedriskforthedevelopmentofhepatocellularcarcinoma.…”

“…11,[21][22][23] Obviously, to reduce the global health burden of HBV infection, in addition to treatmentofchroniccarriers,vaccinationwillneedtobescaled-upto reduceverticaltransmissionandthenumberofnewcases. 23 HDV infects individual HBV carriers since it is necessary for its ownreplication.ChronicHDVinfectionusuallyleadstomoresevere liverdiseasethanHBVmono-infectionandisassociatedwithacceleratedfibrosisprogression,morefrequenthepaticdecompensationand anincreasedriskforthedevelopmentofhepatocellularcarcinoma. 24 WhilePEG-IFN-alphahasprovenantiviralactivityagainstHDV,with aSVR(sustainedundetectableHDVRNA)rateof25%-40%,thecombination of NUCs and IFN was disappointing.…”

Hepatitis B virus envelope proteins can serve as therapeutic targets embedded in the host cell plasma membrane

“…Chronically infected individuals have an increased risk of developing liver fibrosis, cirrhosis and hepatocellular carcinoma (HCC), leading to an estimated 880,000 HBV infection-related deaths per year (WHO, 2017). Available antiviral therapy with nucleos(t)ide analogues suppresses viral replication, but does not cure the infection and has limited impact on the development of hepatocellular carcinoma (Chen, Wang et al, 2017, Debarry, Cornberg et al, 2017, Lobaina & Michel, 2017, WHO, 2017. Therapy with (pegylated) interferon (IFN) alpha is limited by severe side effects.…”

Applicability of Metal Nanoparticles in the Detection and Monitoring of Hepatitis B Virus Infection

“…Infections with the hepatitis B virus (HBV) often become chronic, especially when people are infected at a young age. Chronic HBV infection is strongly associated with the development of liver diseases such as liver cirrhosis and hepatocellular carcinoma, resulting in about one million deaths each year [ 1 , 2 , 3 ]. Although currently no curative therapy for chronic HBV infection is available, treatment of patients with nucleotide analogs or interferon can suppress viral replication and reduce the risk of developing end-stage liver disease.…”