Understanding the Natural History of Hepatitis B Virus Infection and the New Definitions of Cure and the Endpoints of Clinical Trials

Clin Liver Dis. 2019 Aug;23(3):401-416. doi: 10.1016/j.cld.2019.04.002. Epub 2019 Jun 1.

Abstract

Hepatitis B virus (HBV) infection is the most common chronic viral infection worldwide and remains a significant global health problem. Chronic HBV infection can progress to cirrhosis, liver failure, and hepatocellular carcinoma. Outcome of chronic HBV infections depends on the host, virus, and environmental factors. Although effective prophylactic vaccines and antiviral therapies exist, curative treatment is not yet available. Intense research into a cure for HBV is ongoing and proposed definitions of cure and endpoints for clinical trials evaluating "curative" therapy are discussed.

Keywords: Antiviral therapy; Cirrhosis; Hepatitis B e Antigen; Hepatitis B surface antigen; Hepatitis B virus DNA; Hepatocellular carcinoma; Immunotherapy.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • Disease Progression
  • Female
  • Hepatitis B / diagnosis
  • Hepatitis B / drug therapy*
  • Hepatitis B / mortality
  • Hepatitis B e Antigens / immunology*
  • Hepatitis B, Chronic / diagnosis
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis B, Chronic / mortality
  • Humans
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / physiopathology
  • Liver Cirrhosis / virology*
  • Liver Neoplasms / epidemiology*
  • Liver Neoplasms / physiopathology
  • Liver Neoplasms / virology*
  • Male
  • Prevalence
  • Prognosis
  • Risk Assessment
  • Severity of Illness Index
  • Survival Analysis

Substances

  • Hepatitis B e Antigens