Strategies to Eliminate HBV Infection

Rama Kapoor; Shyam Kottilil


Future Virology. 2014;9(6):565-585. 

In This Article

Abstract and Introduction


Chronic HBV infection is a major public health concern affecting over 240 million people worldwide. Although suppression of HBV replication is achieved in the majority of patients with currently available newer antivirals, discontinuation of therapy prior to hepatitis B surface antigen loss or seroconversion is associated with relapse of HBV in the majority of cases. Thus, new therapeutic modalities are needed to achieve eradication of the virus from chronically infected patients in the absence of therapy. The basis of HBV persistence includes viral and host factors. Here, we review novel strategies to achieve sustained cure or elimination of HBV. The novel approaches include targeting the viral and or host factors required for viral persistence, and novel immune-based therapies, including therapeutic vaccines.


Approximately 240 million people worldwide have chronic HBV (CHB).[1] Current therapy for HBV is aimed at achieving suppression of HBV replication at levels below detection. Although this can be accomplished in almost all patients, long-term management of CHB remains a challenge. Failure to achieve sustained response and HBV persistence is related to the viral factors and inadequate induction of immune response that are seen in acute HBV patients, which naturally clears the infection. HLA polymorphisms also determine the variability in host immune response by influencing host susceptibility to HBV infection.

Advancement in the understanding of the basis of HBV persistence has guided the development of strategies that could lead to a functional cure for HBV infection. We discuss the potential strategies under development to achieve a functional cure of hepatitis B by targeting the virus, host or both. Some of these interventions are currently experimental and some have attained preclinical validation, whereas few have reached active clinical trials at this time.