Abstract
Chronic Hepatitis B Virus (HBV) infection poses a significant global health burden. Although, effective treatment and vaccinations against HBV are available, challenges still exist, particularly in the development of curative therapies. The dynamic nature and unique features of HBV such as viral variants, integration of HBV DNA into host chromosomes, and extrahepatic reservoirs are considerations towards understanding the virus biology and developing improved anti-HBV treatments. In this review, we highlight the importance of these viral characteristics in the context of treatment and oncogenesis. Viral genotype and genetic variants can serve as important predictive factors for therapeutic response and outcomes in addition to oncogenic risk. HBV integration, particularly in coding genes, is implicated in the development of hepatocellular carcinoma. Furthermore, we will discuss emerging research that has identified various HBV nucleic acids and infection markers within extrahepatic sites (lymphoid cells). Intriguingly, the presence of hepatocellular carcinoma (HCC)-associated HBV variants and viral integration within the lymphoid cells may contribute towards the development of extrahepatic malignancies. Improved understanding of these HBV characteristics will enhance the development of a cure for chronic HBV infection.
Highlights
The Hepatitis B Virus (HBV) is a significant global viral pathogen
The introduction of the HBV vaccine consisting of recombinant HBV surface antigen (HBsAg) has effectively reduced the spread of HBV, in young children [1]
Within the Calgary Health Zone in Alberta, Canada, our prior research study reported a total of 1214 individuals (0.10% of population within Calgary zone) who tested positive for HBsAg within a single calendar year (2014) [4]
Summary
The Hepatitis B Virus (HBV) is a significant global viral pathogen. An estimated two billion individuals worldwide have been exposed to the virus with approximately 257 million living with chronic HBV infection (CHB) [1]. Within the Calgary Health Zone in Alberta, Canada, our prior research study reported a total of 1214 individuals (0.10% of population within Calgary zone) who tested positive for HBsAg within a single calendar year (2014) [4]. The majority of these cases are likely newly diagnosed CHB carriers, many of which lacked appropriate monitoring and management of their disease. It is noteworthy that persistent HBV infection has unique viral aspects, which affect antiviral treatment choices as well as oncogenic risk These viral features include HBV genotype/genetic variations, integration of HBV DNA into host chromosomes, and recent data suggesting role of viral lymphotropism. HBV genetic variants, integration, and lymphotropism will be discussed as a consideration in the development of new antiviral therapeutics
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