Hepatitis B virus: Advances in prevention, diagnosis, and therapy
Journal
Clinical Microbiology Reviews
Journal Volume
33
Journal Issue
2
Pages
e00046-19
Date Issued
2020
Author(s)
Abstract
Currently, despite the use of a preventive vaccine for several decades as well as the use of effective and well-tolerated viral suppressive medications since 1998, approximately 250 million people remain infected with the virus that causes hepatitis B worldwide. Hepatitis C virus (HCV) and hepatitis B virus (HBV) are the leading causes of liver cancer and overall mortality globally, surpassing malaria and tuberculosis. Linkage to care is estimated to be very poor both in developing countries and in high-income countries, such as the United States, countries in Western Europe, and Japan. In the United States, by CDC estimates, only one-third of HBV-infected patients or less are aware of their infection. Some reasons for these low rates of surveillance, diagnosis, and treatment include the asymptomatic nature of chronic hepatitis B until the very late stages, a lack of curative therapy with a finite treatment duration, a complex natural history, and a lack of knowledge about the disease by both care providers and patients. In the last 5 years, more attention has been focused on the important topics of HBV screening, diagnosis of HBV infection, and appropriate linkage to care. There have also been rapid clinical developments toward a functional cure of HBV infection, with novel compounds currently being in various phases of progress. Despite this knowledge, many of the professional organizations provide guidelines focused only on specific questions related to the treatment of HBV infection. This focus leaves a gap for care providers on the other HBV-related issues, which include HBV's epidemiological profile, its natural history, how it interacts with other viral hepatitis diseases, treatments, and the areas that still need to be addressed in order to achieve HBV elimination by 2030. Thus, to fill these gaps and provide a more comprehensive and relevant document to regions worldwide, we have taken a global approach by using the findings of global experts on HBV as well as citing major guidelines and their various approaches to addressing HBV and its disease burden. ? 2020 American Society for Microbiology.
Subjects
Antiviral therapy; Hepatitis B diagnosis; Hepatitis B management; Hepatitis B treatment
SDGs
Other Subjects
alanine aminotransferase; antivirus agent; complementary DNA; hepatitis B antigen; hepatitis B core antibody; hepatitis B core related antigen; hepatitis B vaccine; hepatitis B(e) antigen; locked nucleic acid; molecular marker; pattern recognition receptor; programmed death 1 receptor; retinoic acid inducible protein I; small interfering RNA; stimulator of the interferon gene; toll like receptor 7; toll like receptor 8; unclassified drug; virus DNA; antivirus agent; alanine aminotransferase blood level; antiviral therapy; clinical evaluation; comorbidity; CRISPR-CAS9 system; delta agent hepatitis; genome analysis; hepatitis B; hepatitis C; human; infection prevention; innate immunity; invasive procedure; life cycle; liver cancer; liver fibrosis; mixed infection; molecular diagnosis; non invasive procedure; pharmacological stimulation; point of care testing; practice guideline; Review; screening test; serology; treatment duration; virus interference; virus pathogenesis; virus reactivation; drug effect; Hepacivirus; hepatitis B; Hepatitis B virus; Human immunodeficiency virus; immunology; laboratory technique; mixed infection; United States; Antiviral Agents; Clinical Laboratory Techniques; Coinfection; Hepacivirus; Hepatitis B; Hepatitis B virus; HIV; Humans; United States
Publisher
American Society for Microbiology
Type
review