title: New insights in the management of chronic hepatitis B.
abstract: Chronic hepatitis B (CHB) remains a global healthcare challenge, complicated by the development of cirrhosis and hepatocellular carcinoma, accounting for approximately 600,000 deaths per year. Hepatitis B is a DNA virus, which utilises a covalently closed circular (ccc) DNA to act as a transcriptional template for the virus. The persistence of cccDNA in the nucleus of infected hepatocytes accounts for HBV chronicity. Quantitative hepatitis B surface antigen (qHBsAg) acts as a surrogate for the level of cccDNA and therefore may provide useful information around treatment response and viral immune control. Current antiviral therapies are limited in their ability to achieve HBsAg loss, which is considered the 'gold-standard' treatment endpoint. This article focuses on the unmet needs in CHB today; a better definition of disease phase, the timing of therapeutic intervention, optimising treatment strategies with current therapies and the development of novel agents; all with HBsAg loss as the therapeutic goal.
authors.affiliation: Centre for Immunology and Infectious Diseases, Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK;
authors.forename: Upkar S
authors.initials: US
authors.lastname: Gill
authors.affiliation: Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK p.kennedy@qmul.ac.uk.
authors.forename: Patrick Tf
authors.initials: PT
authors.lastname: Kennedy
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D006801:Humans
chemical_list: D000998:Antiviral Agents
keywords: HCC; cccDNA; disease phase; liver biopsy; nucleos(t)ide analogues; pegylated interferon; quantitative HBsAg; transient elastography
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