Overview of the immunological mechanisms in hepatitis B virus reactivation: Implications for disease progression and management strategies

Table 2 Strategies for the management of hepatitis B virus reactivation

Therapy	Model	Mechanism	Efficacy	Success rate, %	Resistance	Ref.
Anti-viral therapy
Nucleos(t)ide	Lamivudine	Inhibits viral DNA synthesis	High	80%	Low	[30]
	Entecavir	Potent viral DNA polymerase	High	90%	Rare	[120]
	Adefovir	Inhibits viral DNA polymerase	Moderate	70%-80%	Occasional	[128]
	Tenofovir	Inhibits viral DNA synthesis	High	90%	Rare	[124]
Monoclonal antibodies	Anti-HBV antibodies	Viral neutralization	Moderate	70%	Occasional	[137]
Combination therapy	Tenofovir + emtricitabine	Inhibits viral DNA synthesis	High	95%	Low	[138]
Immune-modulating therapy
	Toll-like receptor agonists	Immune activation	Moderate	70%	Variable	[139]
	Interferon	Antiviral and immune activation	High	80%	Occasional	[140]
Personalized treatment approaches
	Tailored	Targeted antiviral therapy based on genomic profile	Variable	75%-90%	Variable	[141]
	Treatment
Combination therapy	Nucleos(t)ide + immune-modulating therapy	Antiviral + immunomodulation	High	90%-95%	Low	[142]
Monoclonal antibodies	Individualized treatment	Targeted viral neutralization based on antibody profiling	Varies	60%-80%	Occasional	[143]