Liver Diseases pp 599-609 | Cite as

Specific Medications for Chronic Viral Hepatitis

  • Daniela GabbiaEmail author
  • Sara De MartinEmail author


Infections caused by hepatitis viruses will probably increase at least until 2020 and represents a global health concern, due to their still significant morbidity and mortality. Both hepatitis B (HBV) and C (HCV) may progress to chronic hepatic infection. Patients affected by chronic HBV and HCV are at risk for developing cirrhosis, liver failure, and hepatocellular carcinoma. Whilst HBV is a vaccine-preventable disease, no vaccine is available to prevent HCV. However, HCV is currently a curable disease with different available therapeutic options, whereas the current drugs for HBV (e.g. IFN, the nucleoside/nucleotide analogues entecavir and tenofovir) are not completely curative. The direct-acting antivirals (DAAs), whose “first-in-class” is sofosbuvir, are often used in combination regimens and have dramatically improved HCV treatment, due to their satisfactory safety profiles and efficacy. Several concerns still remain to be addresses in the management of chronic viral hepatitis. In particular, new antiviral therapies, able to target selectively different pathways of HBV cell cycle and restore the immune response of the patients, as well as new diagnostic techniques and a global access to the expensive therapies for HCV represent future goals in the therapeutic approach to these liver diseases.


Hepatitis B virus Hepatitis C virus Chronic hepatitis Nucleos(t)ide analogues (NAs) Direct-acting antivirals (DAAs) Pharmacological regimens for hepatitis viruses 


  1. 1.
    Harris RJ, Thomas B, Griffiths J, Costella A, Chapman R, Ramsay M, et al. Increased uptake and new therapies are needed to avert rising hepatitis C-related end stage liver disease in England: modelling the predicted impact of treatment under different scenarios. J Hepatol [Internet]. 2014 [cited 2018 Sep 27];61:530–7. Available from: Scholar
  2. 2.
    WHO. Global hepatitis report, 2017. Geneva: World Health Organization; 2017.Google Scholar
  3. 3.
    Tu T, Bühler S, Bartenschlager R. Chronic viral hepatitis and its association with liver cancer. Biol Chem [Internet]. 2017 [cited 2018 Sep 27];398:817–37. Available from: Scholar
  4. 4.
    Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet (London, England) [Internet]. 2015 [cited 2018 Sep 27];386:1546–55. Available from:
  5. 5.
    Lok ASF, McMahon BJ, Brown RS, Wong JB, Ahmed AT, Farah W, et al. Antiviral therapy for chronic hepatitis B viral infection in adults: a systematic review and meta-analysis. Hepatology [Internet]. 2016 [cited 2018 Sep 27];63:284–306. Available from:
  6. 6.
    Terrault NA, Bzowej NH, Chang K-M, Hwang JP, Jonas MM, Murad MH, et al. AASLD guidelines for treatment of chronic hepatitis B. Hepatology [Internet]. 2016 [cited 2018 Sep 27];63:261–83. Available from:
  7. 7.
    Marcellin P, Ahn SH, Chuang W-L, Hui AJ, Tabak F, Mehta R, et al. Predictors of response to tenofovir disoproxil fumarate plus peginterferon alfa-2a combination therapy for chronic hepatitis B. Aliment Pharmacol Ther [Internet]. 2016 [cited 2018 Sep 27];44:957–66. Available from:
  8. 8.
    Marcellin P, Ahn SH, Ma X, Caruntu FA, Tak WY, Elkashab M, et al. Combination of tenofovir disoproxil fumarate and peginterferon α-2a increases loss of hepatitis B surface antigen in patients with chronic hepatitis B. Gastroenterology [Internet]. 2016 [cited 2018 Sep 27];150:134–44.e10. Available from:
  9. 9.
    Mazzaro C, Dal Maso L, Urraro T, Mauro E, Castelnovo L, Casarin P, et al. Hepatitis B virus related cryoglobulinemic vasculitis: a multicentre open label study from the Gruppo Italiano di Studio delle Crioglobulinemie - GISC. Dig Liver Dis [Internet]. 2016 [cited 2018 Sep 27];48:780–4. Available from:
  10. 10.
    Brown RS, McMahon BJ, Lok ASF, Wong JB, Ahmed AT, Mouchli MA, et al. Antiviral therapy in chronic hepatitis B viral infection during pregnancy: a systematic review and meta-analysis. Hepatology [Internet]. 2016 [cited 2018 Sep 27];63:319–33. Available from: Scholar
  11. 11.
    Jonas MM, Lok ASF, McMahon BJ, Brown RS, Wong JB, Ahmed AT, et al. Antiviral therapy in management of chronic hepatitis B viral infection in children: a systematic review and meta-analysis. Hepatology [Internet]. 2016 [cited 2018 Sep 27];63:307–18. Available from: Scholar
  12. 12.
    Polaris Observatory HCV Collaborators, Zeuzem S, Manns M, Altraif I, Duberg A-S, Muljono DH, et al. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol [Internet]. 2017 [cited 2018 Sep 27];2:161–76. Available from:
  13. 13.
    European Union HCV Collaborators, Robbins S, Zeuzem S, Negro F, Buti M, Duberg A-S, et al. Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030: a modelling study. Lancet Gastroenterol Hepatol [Internet]. 2017 [cited 2018 Sep 27];2:325–36. Available from:
  14. 14.
    Pawlotsky J-M, Negro F, Aghemo A, Berenguer M, Dalgard O, Dusheiko G, et al. EASL recommendations on treatment of hepatitis C 2018. J Hepatol [Internet]. 2018 [cited 2018 Sep 27];69:461–511. Available from:
  15. 15.
    Chung RT, Ghany MG, Kim AY, Marks KM, Naggie S, Vargas HE, et al. Hepatitis C guidance 2018 update: AASLD-IDSA recommendations for testing, managing, and treating hepatitis C virus infection. Clin Infect Dis [Internet]. 2018 [cited 2018 Sep 28]. Available from:
  16. 16.
    AASLD/IDSA HCV Guidance Panel. Hepatitis C guidance: AASLD-IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus. Hepatology [Internet]. 2015 [cited 2018 Sep 27];62:932–54. Available from:
  17. 17.
    Bogomolov P, Alexandrov A, Voronkova N, Macievich M, Kokina K, Petrachenkova M, et al. Treatment of chronic hepatitis D with the entry inhibitor myrcludex B: first results of a phase Ib/IIa study. J Hepatol [Internet]. 2016 [cited 2018 Sep 27];65:490–8. Available from: Scholar
  18. 18.
    Blank A, Markert C, Hohmann N, Carls A, Mikus G, Lehr T, et al. First-in-human application of the novel hepatitis B and hepatitis D virus entry inhibitor myrcludex B. J Hepatol [Internet]. 2016 [cited 2018 Sep 27];65:483–9. Available from: Scholar
  19. 19.
    Al-Mahtab M, Bazinet M, Vaillant A. Safety and efficacy of nucleic acid polymers in monotherapy and combined with immunotherapy in treatment-naive Bangladeshi patients with HBeAg+ chronic hepatitis B infection. PLoS One [Internet]. 2016 [cited 2018 Sep 27];11:e0156667. Available from: Scholar
  20. 20.
    Durantel D, Zoulim F. New antiviral targets for innovative treatment concepts for hepatitis B virus and hepatitis delta virus. J Hepatol [Internet]. 2016 [cited 2018 Sep 27];64:S117–31. Available from: Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Pharmaceutical and Pharmacological SciencesUniversity of PadovaPadovaItaly

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