Immune balance in Hepatitis B Infection: Present and Future Therapies

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 main...

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Bibliographic Details
Published in:Scandinavian journal of immunology 2017-07, Vol.86 (1), p.4-14
Main Authors: Vyas, A. K., Jindal, A., Hissar, S., Ramakrishna, G., Trehanpati, N.
Format: Article
Language:English
Subjects:
Acute-On-Chronic Liver Failure - immunology
Acute-On-Chronic Liver Failure - therapy
Antiviral Agents - immunology
Antiviral Agents - therapeutic use
Chronic active hepatitis
Chronic infection
Flares
Forecasting
Hepatitis
Hepatitis B
Hepatitis B - immunology
Hepatitis B - therapy
Hepatitis B - virology
Hepatitis B surface antigen
Hepatitis B Vaccines - immunology
Hepatitis B Vaccines - therapeutic use
Hepatitis B virus - drug effects
Hepatitis B virus - immunology
Hepatitis B virus - physiology
Hepatitis B, Chronic - immunology
Hepatitis B, Chronic - therapy
Hepatitis B, Chronic - virology
Humans
Immune clearance
Immune response
Immune status
Immunomodulation
Immunotherapy - methods
Immunotherapy - trends
Infections
Interferon
Liver
Liver diseases
Nucleoside analogs
Replication
Toll-like receptors
Virus Replication - drug effects
Virus Replication - immunology
Viruses
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Summary: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.
ISSN:0300-9475
1365-3083
DOI:10.1111/sji.12553