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Abstract Details
Emerging tools in the changing landscape of chronic hepatitis B management
Gill US1, Battisti A1, Kennedy PT1. Expert Rev Anti Infect Ther. 2019 Nov 18. doi: 10.1080/14787210.2019.1694906. [Epub ahead of print]
Author information
1 Barts Liver Centre, Centre for Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK.
Abstract
Introduction: The availability of a preventative vaccine, interferon and nucleos(t)ide analogues have provided progress in the control of chronic hepatitis B (CHB). Despite this it remains a major contributor to global morbidity and mortality. Developments in our understanding of the pathogenesis of CHB and the emergence of new therapies are paving the way, as we move towards HBV cure.Areas covered: We performed bibliographical searches of online databases to review the literature regarding conventional disease phases of CHB. We provide the latest evidence challenging the perception of the natural history of CHB, noting that previously considered quiescent disease phases, may not represent benign disease states devoid of progression. We explore the use of potential novel immunological and viral tools which should enhance disease stratification and management decisions in the coming years. Finally, we discuss the timing of treatment and how this could be initiated earlier to improve treatment outcomes, preventing sequelae of chronic infection.Expert opinion: The treatment paradigm in CHB is set to change with multiple novel agents in early phase clinical trials with the aim of functional cure. An improved understanding of disease pathogenesis and the timing of treatment will be critical to the success of new therapies.