Title:Chronic Hepatitis B Infection: Current and Emerging Therapeutic
Strategies
Volume: 23
Issue: 18
Author(s): Ankita Singh, Jitendra Kumar and Vijay Kumar*
Affiliation:
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
Keywords:
Hepatitis B, Cancer, Chronic liver disease, DNA, HBV infection, Immune system.
Abstract: The chronic infection of the hepatitis B virus (CHB) represents a major public health
problem worldwide. Despite the availability of an effective prophylactic vaccine, millions of hepatitis
B patients are at increased risk of developing chronic liver disease. The currently available
treatments for HBV infection include interferon and nucleos(t)ide analogues that are effective at
suppressing viral load and preventing or delaying the progression of liver disease. However, these
treatments offer somewhat unsatisfactory clinical cures due to the persistence of the intrahepatic
pool of covalently closed circular DNA (cccDNA) that serves as a reservoir for viral progenies and
a potential source of recurring infections. Elimination of viral cccDNA remains a challenge for scientists
and pharmaceutical industries in order to achieve the eradication and control of HBV infection.
This would involve a detailed understanding of the molecular mechanisms of cccDNA formation,
its intracellular stability, and regulation during replication and transcription. Recent advances
in drug therapy have heralded a new horizon of novel therapeutic approaches for CHB infection,
with several promising antiviral and immunomodulatory agents currently in preclinical or clinical
testing. However, approval of any new curative therapy would involve rigorous evaluation of
the efficacy and safety of each treatment and defining correct endpoints associated with improved
clinical outcomes. This article summarizes the current landscape of HBV treatments, and drugs in
clinical trials and highlights the most recent anti-HBV small molecules designed to directly target
HBV or to improve immune response during chronic infection.