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Updates on Chronic HBV: Current Challenges and Future Goals

  • Hannah M. LeeEmail author
  • Bubu A. Banini
Liver (J Bajaj, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Liver

Abstract

Purpose of Review

Chronic HBV (CHB) remains a global public health problem with over 257 million people chronically infected worldwide. Without appropriate management, 20% of individuals infected with CHB will die from complications of cirrhosis, liver failure, or hepatocellular carcinoma (HCC). Despite an effective vaccination to prevent infection, HBV has yet to be successfully eradicated globally. Current treatments can only control and suppress the virus but cannot cure. Updates in the management of chronic HBV will be reviewed, including latest treatments and treatment strategies as well as potential curative therapeutic agents in clinical trial.

Recent Findings

A new nucleotide analogue drug, tenofovir alafenamide fumarate (TAF), has been added to the HBV therapeutic armamentarium. A more potent drug showing non-inferiority, TAF has shown to improve renal and bone laboratory safety parameters compared to TDF. In addition, new treatment recommendations have been made for both general and special populations including pregnancy and HBV reactivation. There is growing data supporting the importance of antiviral therapy in patients with advanced liver disease and liver decompensation which has resulted in improved outcomes. In addition, at least 30 potential therapeutics are in clinical trials in the pursuit of curative treatments for chronic HBV with the goal of “functional cure.”

Summary

CHB remains a global public health problem with complications including cirrhosis, liver failure, and HCC. Current antiviral therapy can cause reversal of liver disease, improve outcomes, and prevent complications such as reactivation but still requires long-term use. Curative treatments for HBV are greatly needed with promising curative drugs in early phase studies.

Keywords

Chronic hepatitis B Antiviral therapy Nucleoside analogue Functional cure Reactivation Perinatal transmission 

Notes

Author Contributions

Authored first draft (HL) (pregnancy, future therapeutics—BB)

Critical revision (HL/BB)

Approved final draft (HL)

Compliance with Ethical Standards

Conflict of Interest

Hannah Lee declares that she has no conflict of interest. Bubu Banini declares that she has no conflict of interest.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Gastroenterology, Hepatology and NutritionVirginia Commonwealth University Medical CenterRichmondUSA

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