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Future Drugs in the Treatment of HBV

  • Aslıhan Demirel
  • Resat Ozaras
Chapter

Abstract

Chronic hepatitis B (CHB) virus infection, a major cause of cirrhosis and hepatocellular carcinoma (HCC), is a global public health problem. The treatment of CHB progressed during the last decades. Beginning with IFN and Peg-IFN, hepatitis B virus (HBV) treatment improved with the use of potent and safe antivirals. The newer antiviral agents, entecavir and tenofovir, are more potent and, with higher resistance barrier, have provided lifelong suppression of HBV replication. However, long-term use of HBV antivirals does not provide eradication.

The new strategy to completely cure CHB is described as the physical elimination of cccDNA, in addition to functional cure (HBsAg loss with or without anti-HB seroconversion, with undetectable serum DNA). This strategy may facilitate the implementation of antiviral treatments for a finite period of time, may reduce their cost, may increase drug accessibility to populations in highly endemic areas, and may have an impact on development of cirrhosis and HCC.

To provide a complete cure, the prominent promising agents are HBsAg release inhibitors, HBV entry inhibitors, antiviral effector cells that are stimulated, therapeutic vaccines, DNA vaccines, anti-cccDNA agents, and new antivirals, including tenofovir alafenamide, and besifovir. These drugs are in either preclinical or clinical levels of development.

Combinations of viral- and host-mediated drugs are promising to sustain the goal of complete cure in the near future.

Keywords

Chronic hepatitis B Complete cure HBsAg release inhibitors HBV entry inhibitors Therapeutic vaccines Anti-cccDNA agents Tenofovir alafenamide Besifovir 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Aslıhan Demirel
    • 1
  • Resat Ozaras
    • 2
  1. 1.Department of Infectious Diseases and Clinical MicrobiologyFlorence Nightingale Hospital, Bilim UniversityIstanbulTurkey
  2. 2.Department of Infectious Diseases and Clinical MicrobiologyCerrahpasa Medical School, Istanbul UniversityIstanbulTurkey

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