Abstract
Hepatitis B virus infection affects over 250 million chronic carriers, causing more than 800,000 deaths annually, although a safe and effective vaccine is available. Currently used antiviral agents, pegylated interferon and nucleos(t)ide analogues, have major drawbacks and fail to completely eradicate the virus from infected cells. Thus, achieving a “functional cure” of the infection remains a real challenge. Recent findings concerning the viral replication cycle have led to development of novel therapeutic approaches including viral entry inhibitors, epigenetic control of cccDNA, immune modulators, RNA interference techniques, ribonuclease H inhibitors, and capsid assembly modulators. Promising preclinical results have been obtained, and the leading molecules under development have entered clinical evaluation. This review summarizes the key steps of the HBV life cycle, examines the currently approved anti-HBV drugs, and analyzes novel HBV treatment regimens.
Highlights
Hepatitis B is a liver disease caused by the Hepatitis B Virus (HBV)
Two types of treatment are currently available against hepatitis B viral infection, interferon α derivatives (IFNs), and nucleos(t)ide analogues (NAs)
NAs which are administered per os, require long-term duration of therapy, achieve better control of HBV replication, and show many fewer side effects compared to PEG-Interferon α (IFN-α)
Summary
Hepatitis B is a liver disease caused by the Hepatitis B Virus (HBV). HBV belongs to the Hepadnaviridae family and is classified into ten genotypes (A to J) [1]. The goal of the current therapeutic development is a “functional cure” defined as sustained undetectable levels of HBsAg and HBV DNA in serum, with or without seroconversion to hepatitis B surface antibodies (anti-HBs) after the end of the treatment [7]. This reduction has been associated with an improved clinical condition and significantly decreased the chance of infection rebound. Rapid disease progression [11] These biomarkers areexisting used to guide treatment decisions summarizes the HBV replication cycle, the treatment options and following their significant guidelines established by the major hepatology medical societies [12,13,14]. With the ultimate goal of achieving a “functional cure” of the disease
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