Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Jul 5, 2021; 12(4): 56-78
Published online Jul 5, 2021. doi: 10.4292/wjgpt.v12.i4.56
Advances in treatment and prevention of hepatitis B
Niraj James Shah, Mark M Aloysius, Neil Rohit Sharma, Kumar Pallav
Niraj James Shah, Department of Internal Medicine, Digestive Disease, University of Mississippi Medical Center, Jackson, MS 39216, United States
Mark M Aloysius, Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA 18505, United States
Neil Rohit Sharma, Kumar Pallav, Department of Internal Medicine, Interventional Oncology and Surgical Endoscopy, Parkview Regional Medical Center, Parkview Cancer Institute, Fort Wayne, IN 46845, United States
Author contributions: Shah NJ, Aloysius MM, Sharma NR, and Pallav K performed the conception and design of the review article, acquisition of material, analysis and interpretation of material, critical revision, drafting the article, revising the paper, and its final approval.
Conflict-of-interest statement: All authors deny conflict of interest of any nature related to the article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Kumar Pallav, MBBS, Academic Fellow, Department of Internal Medicine, Interventional Oncology and Surgical Endoscopy, Parkview Regional Medical Center, Parkview Cancer Institute, 11050 Parkview Plaza Dr., Fort Wayne, IN 46845, United States.
Received: January 26, 2021
Peer-review started: January 26, 2021
First decision: March 7, 2021
Revised: March 22, 2021
Accepted: May 22, 2021
Article in press: May 22, 2021
Published online: July 5, 2021

Chronic hepatitis B (CHB) continues to contribute to worldwide morbidity and mortality significantly. Scientists, clinicians, pharmaceutical companies, and health organizations have dedicated substantial Intellectual and monetary resources to finding a cure, increasing immunization rates, and reducing the global burden of CHB. National and international health-related organizations including the center for disease control, the national institute of health, the American Association for the study of liver disease (AASLD), The European association for the study of the Liver (EASL), The Asia Pacific association for the study of the Liver (APASL) and the world health organization release periodic recommendations for disease prevention and treatment. Our review of the most recent guidelines by EASL, AASLD, APASL, and Taiwan Association for the Study of the Liver revealed that an overwhelming majority of cited studies were published before 2018. We reviewed Hepatitis B-related literature published 2018 onwards to identify recent developments and current barriers that will likely direct future efforts towards eradicating hepatitis B. The breakthrough in our understanding of the hepatitis B virus life cycle and resulting drug development is encouraging with significant room for further progress. Data from high-risk populations, most vulnerable to the devastating effects of hepatitis B infection and reactivation remain sparse. Utilization of systems approach, optimization of experimental models, identification and validation of next-generation biomarkers, and precise modulation of the human immune response will be critical for future innovation. Within the foreseeable future, new treatments will likely complement conventional therapies rather than replace them. Most Importantly, pragmatic management of CHB related population health challenges must be prioritized to produce real-world results.

Keywords: Chronic hepatitis B, Hepatitis B virus, Hepatitis B prevention, Hepatitis B treatment, Hepatitis B vaccination, Hepatitis B reactivation

Core Tip: Given the hepatitis B viral life cycle’s unique characteristics, a true cure is lacking. Most recent guidelines from multiple societies including the American Association for the Study of Liver Diseases, the European Association for the Study of the Liver, Asia Pacific Association for the Study of the Liver, and Taiwan Association for the Study of the Liver, primarily include data published before 2018. A significant amount of hepatitis B relevant literature has been published since 2018. Our manuscript aims to review the recent literature for new developments and to identify the global strategies and knowledge gaps that will soon shape the scientific endeavor in this field.