title: Immune balance in Hepatitis B Infection: Present and Future Therapies.
abstract: Chronic hepatitis B virus (HBV) infection affects millions of people worldwide and about half a million people die every year. India represents the second largest pool of chronic HBV infections with an estimated 40 million chronically infected patients. Persistence or clearance of HBV infection mainly depends upon host immune responses. Chronically infected individuals remain in immune tolerant phase unless HBV flares and leads to the development of chronic active hepatitis or acute-on-chronic liver failure. Strategies based on inhibition of viral replication (nucleoside analogues) or immune modulation (interferons) as monotherapy, or in combination in sequential therapies, are currently being used globally for reducing HBV viral load and mediating HBsAg clearance. However, the immune status and current therapies for promoting sustained virological responses in HBV-infected patients remain suboptimal. Elimination of cccDNA is major challenge for future therapies, and new molecules such as NTCP, Toll-like receptor (TLR)7 agonist (GS9620) and cyclophilin have emerged as potential targets for preventing HBV entry and replication. Other than these, HBV cccDNA elimination is the major target for future therapies.
authors.affiliation: Department of Molecular and Cellular Medicine, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Vyas
authors.affiliation: Department of Hepatology, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Jindal
authors.affiliation: Department of Molecular and Cellular Medicine, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Hissar
authors.affiliation: Department of Molecular and Cellular Medicine, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: G
authors.initials: G
authors.lastname: Ramakrishna
authors.affiliation: Department of Molecular and Cellular Medicine, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: N
authors.identifier: http://orcid.org/0000-0002-6109-0033
authors.initials: N
authors.lastname: Trehanpati
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000276:immunology* / Q000628:therapy; D000998:Antiviral Agents / Q000276:immunology / Q000627:therapeutic use; D005544:Forecasting; D006509:Hepatitis B / Q000276:immunology* / Q000628:therapy / Q000821:virology; D017325:Hepatitis B Vaccines / Q000276:immunology / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects / Q000276:immunology* / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000276:immunology* / Q000628:therapy / Q000821:virology; D006801:Humans; D007167:Immunotherapy / Q000379:methods / Q000639:trends; D014779:Virus Replication / Q000187:drug effects / Q000276:immunology
chemical_list: D000998:Antiviral Agents; D017325:Hepatitis B Vaccines