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Current therapeutic approaches for HBV infected patients

  • Upkar S. Gill
    Affiliations
    Centre for Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, QMUL, London, UK
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  • Patrick T.F. Kennedy
    Correspondence
    Corresponding author: Blizard Institute, Barts and The London School of Medicine & Dentistry, 4 Newark Street, London E1 2AT, UK. Tel.: +44 207 882 2383; fax: +44 207 882 718.
    Affiliations
    Centre for Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, QMUL, London, UK
    Search for articles by this author
      Chronic hepatitis B (CHB) is traditionally thought to progress through distinct disease phases; HBeAg positive chronic infection, HBeAg positive chronic hepatitis, HBeAg negative chronic infection and HBeAg negative chronic hepatitis (formerly referred to as immune tolerant, immune clearance, immune control and immune escape respectively).
      European Association for the Study of the Liver
      EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection.
      • Zoulim F.
      • Mason W.S.
      Reasons to consider earlier treatment of chronic HBV infections.
      Treatment is usually reserved for those patients with HBeAg positive or negative chronic hepatitis, with evidence of clinically active disease and the presence of fibrosis.
      European Association for the Study of the Liver
      EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection.
      Treatment candidacy has been largely based on biochemical and virological parameters, however, recent data have demonstrated that the early phase of the disease may not be as benign as previously believed; thus these patients may benefit from early treatment.
      • Zoulim F.
      • Mason W.S.
      Reasons to consider earlier treatment of chronic HBV infections.
      • Kennedy P.T.
      • et al.
      Preserved T-cell function in children and young adults with immune-tolerant chronic hepatitis B.
      • Mason W.S.
      • et al.
      HBV DNA integration and clonal hepatocyte expansion in chronic hepatitis B patients considered immune tolerant.
      In addition, it is widely recognised that antiviral therapy can prevent cirrhosis and reduce the development of hepatocellular carcinoma (HCC).
      • Marcellin P.
      • et al.
      Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study.
      In this article we discuss currently licensed therapies, along with novel pipeline therapies for HBV and their impact on host-viral immunity.

      Keywords

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