Advances in HBV infection: new markers and treatments

Abstract

Hepatitis B virus (HBV) is one of the commonest infectious diseases worldwide. Its history dated back to 4500 years ago, with HBV DNA genome earliest found in skeletons from the Bronze Age. Until 1965, Dr. Blumberg discovered the presence of hepatitis B surface antigen (HBsAg) and this marked the beginning of the battle with HBV in modern medicine. Several serological markers are discovered after years of research from clinicians and scientists, e.g. HBV DNA levels in serum, intrahepatic HBV DNA levels, hepatitis B e antigen, and quantitative HBsAg levels. These markers are useful in predicting disease courses, occurrence of complication and relapse after treatment cessation. In recent years, there are two new serological markers of HBV being investigated extensively, i.e. hepatitis B core-related antigen (HBcrAg) and HBV RNA. These markers would be useful in specific circumstances to help further stratify patient risks. Despite the effective treatment with nucleoside and nucleotide analogues, the rate of HBsAg seroclearance remains low. With the goal of achieving functional cure, i.e. HBsAg seroclearance, as a treatment endpoint, new treatment for chronic hepatitis B is sought-after. There are several potential drugs under investigation, for example siRNA and capsid assembly modulators.