Future aspects of therapy for hepatitis B virus infection: value of surrogate markers, innovative therapy, and global collaboration

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Future aspects of therapy for hepatitis B virus infection: value of surrogate

markers, innovative therapy, and global collaboration

Journal of Gastroenterology, 05/12/2011  Review Article

Akbar SMF et al. - New and more effective therapeutic regimens for chronic

hepatitis B patients are needed that take into account potential surrogate

markers of treatment outcomes and allow for effective collaboration between

resource-constrained and advanced countries.

• Both optimism and frustration exist regarding therapy for patients with

chronic hepatitis B virus infection.

• Due to the recent advent of several drugs with potent antiviral capacities

and comparatively low rates of adverse effects, considerable optimism has

developed regarding the treatment of these patients.

• Chronic hepatitis B is now a treatable disease, and suppression of hepatitis

B virus replication, normalization of alanine aminotransferase levels,

seronegativity/seroconversion of hepatitis B e antigen and hepatitis B surface

antigen, and decreased hepatic inflammation and liver fibrosis have been

documented in chronic hepatitis B virus-infected patients treated with antiviral

therapy.

• In contrast, many frustrations regarding antiviral therapy for chronic

hepatitis B have arisen, because the disease, although treatable, is not

curable.

• The present regimens of antiviral therapy modulate some intermediate

parameters or so-called surrogate markers in chronic hepatitis B virus-infected

patients, but usually fail to improve all intermediate parameters or ultimate

clinical outcomes.

• In addition, major concerns remain about the applicability and use of

antiviral drugs in developing and resource-constrained countries in which

healthcare delivery systems do not support the proper use of antiviral therapy.