Global importance of new treatment strategies to efforts to control hepatitis B virus

Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(8):847-862. doi: 10.1080/14787210.2023.2225771. Epub 2023 Jun 23.


Introduction: Hepatitis B Virus (HBV) infection can progress to chronic HBV (CHB) disease, thereby increasing the risk of severe forms of liver disease (i.e. liver cirrhosis and hepatocellular carcinoma) and resulting in a high global burden of morbidity, mortality, and health-care utilization.

Areas covered: We discuss how future therapeutic strategies and treatment guidelines may address the large unmet medical needs among patients with CHB.

Expert opinion: Complexity and a lack of consensus in current CHB treatment guidelines may limit their effective implementation. To minimize poor outcomes in patients not currently receiving treatment (including immune-tolerant and inactive carriers), a simplified harmonized treatment approach is needed across guidelines. Current treatment recommendations focus on nucleot(s)ide analogs (NAs) and pegylated interferon (Peg-IFN), both of which have limitations. NAs provide clinical benefits, but treatment is prolonged and has little impact on functional cure rates. Peg-IFN offers the potential for functional cure but has notable safety and tolerability issues. A shift toward finite treatments with acceptable safety and tolerability profiles is needed.

Conclusion: The key to achieving World Health Organization targets for the global eradication of HBV involves enhanced diagnosis with new treatments and/or combinations of existing treatments alongside globally aligned and simplified treatment guidelines for untreated/inadequately treated populations.

Keywords: Burden; CHB; HBV; guidelines; treatment, unmet need.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / adverse effects
  • Hepatitis B virus
  • Hepatitis B* / drug therapy
  • Hepatitis B* / prevention & control
  • Hepatitis B, Chronic*
  • Humans
  • Interferon-alpha
  • Liver Neoplasms* / prevention & control


  • Antiviral Agents
  • Interferon-alpha