Newer Therapies in HBV

Newer Therapies in HBV

  • Complex hepatitis B virus (HBV) life cycle and current treatment are dependent on nucleos(t)ide analogues (NAs).
  • A partial or functional cure is not enough, hence is crucial to target covalently covalently closed circular DNA (cccDNA) for a complete cure.
  • Entry inhibitors are approved for chronic HDV, however, they do not address cccDNA.
  • Attractive options for targeting cccDNA are – Inhibition of mini chromosomes and silencing transcription. Concerns over genomic stability are still hindrances.
  • Post-transcriptional control – Antisense oligonucleotides (ASOs) and small interfering RNAs (siRNAs). Do not eliminate cccDNA, rebound post-treatment.
  • Capsid assembly modulators (CAMs) are the best among the present novel therapies. They cause long-term suppression of HBV DNA and RNA.
  • S-antigen transport-inhibiting oligonucleotide polymers (STOPS) and nucleic acid polymers (NAPs) have given promising results, however, need further studies.
  • Good results have been obtained for TLR7, the combination of RIG with IFN, and promising results of vaccination in the phase III trial.
  • Multiple combination strategies under investigation need larger and longer trials.

Dr. Anil Arora

A patient focused Gastroenterologist & Hepatologist, offering over 35 years, currently spearheading functions as Chairman of Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Ganga Ram Institute of Post Graduate Medical Education and Research of Sir Ganga Ram Hospital Rajinder nagar New Delhi. Dr Anil Arora completed MBBS from the All India Institute of Medical Sciences, New Delhi in 1982, following which he did his MD in medicine from the same institution in 1986. He went on to do his DNB - Medicine from National Board of Examination, New Delhi in 1987 and DM - Gastro from the All India Institute of Medical Sciences, New Delhi in 1989.


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