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Current Treatment Options in Gastroenterology

Published in:

01-06-2019 | Hepatitis B | Liver (J Bajaj, Section Editor)

Updates on Chronic HBV: Current Challenges and Future Goals

Authors: Hannah M. Lee, MD, Bubu A. Banini, MD PhD

Published in: Current Treatment Options in Gastroenterology | Issue 2/2019

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.

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Title: Updates on Chronic HBV: Current Challenges and Future Goals
Authors: Hannah M. Lee, MD
Bubu A. Banini, MD PhD
Publication date: 01-06-2019
Publisher: Springer US
Keywords: Hepatitis B
Vaccination
Hepatocellular Carcinoma
Hepatocellular Carcinoma
Published in: Current Treatment Options in Gastroenterology / Issue 2/2019
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI: https://doi.org/10.1007/s11938-019-00236-3

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STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

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