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Semin Liver Dis 2017; 37(03): 231-242
DOI: 10.1055/s-0037-1606212
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Challenges to a Cure for HBV Infection

Barbara Testoni
1   INSERM, U1052, Lyon, France
2   Cancer Research Center of Lyon (CRCL), Lyon, France
3   University of Lyon, UMR_S1052, UCBL, Lyon, France
,
Massimo Levrero
1   INSERM, U1052, Lyon, France
2   Cancer Research Center of Lyon (CRCL), Lyon, France
4   Hospices Civils de Lyon (HCL), Lyon, France
5   Department of Internal Medicine - DMISM, Sapienza University, Rome, Italy
6   CLNS@SAPIENZA, Istituto Italiano di Tecnologia (IIT), Rome, Italy
,
Fabien Zoulim
1   INSERM, U1052, Lyon, France
2   Cancer Research Center of Lyon (CRCL), Lyon, France
3   University of Lyon, UMR_S1052, UCBL, Lyon, France
4   Hospices Civils de Lyon (HCL), Lyon, France
› Author Affiliations
Further Information

Publication History

Publication Date:
28 August 2017 (online)

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Abstract

Current first-choice treatments for chronic hepatitis B are able to efficiently induce viral suppression in the majority of patients, but life-long therapy is needed to maintain infection under control due to their inability to eliminate the virus from infected hepatocytes. The residual viral replication and antigen production in most patients under treatment substantially contributes to the residual risk of hepatocarcinogenesis. New therapeutic approaches are needed to overcome hepatitis B virus persistence in the infected cells, or at least to control its transcriptional and replicative activity. In this review, the authors discuss the key points of the viral life cycle and host immune responses that need to be addressed to achieve a “functional cure,” or even a “complete cure,” allowing a finite duration of treatment and preventing virus reactivation and liver disease progression in a significantly higher number of patients than what is currently attained.

Keywords

chronic hepatitis B (CHB) - covalently-closed-circular DNA - hepatitis B virus (HBV) integration - HBV cure - clinical endpoints - surrogate markers
 

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