Advances in determining new treatments for hepatitis B infection by utilizing existing and novel biomarkers

IntroductionChronic hepatitis B (CHB) infection is a major global health threat and accounts for significant liver-related morbidity and mortality. An improved understanding of how hepatitis B virus (HBV) interacts with the host immune system allows the discovery of novel biomarkers and new treatment options. Viral biomarkers including hepatitis B surface antigen (HBsAg) and newer ones like HBV RNA and hepatitis B core-related antigen appear to be useful to select patients who are likely to benefit from cessation of long-term antiviral therapy. These markers can also help to confirm target engagement for novel compounds, and efficacy in HBsAg reduction and seroclearance is deemed essential as this is how the current treatment endpoint of functional cure is defined.Areas coveredIn this review, the authors discuss the current standard of care and the gaps between such standard and the ideal goals for treatment in CHB. The authors highlight novel viral and immunological biomarkers that are potentially useful to evaluate treatment response. Novel treatment approaches in relation to these novel biomarkers are also evaluated.Expert opinionNovel serum viral biomarkers and immunological markers are indispensable in the HBV functional cure program. These will likely become part of standard monitoring soon.

Automated summary

Chronic hepatitis B (CHB) infection is a significant global health threat, and understanding the interaction between hepatitis B virus (HBV) and the host immune system can lead to the discovery of new biomarkers and treatment options. Viral biomarkers such as HBsAg, HBV RNA, and hepatitis B core-related antigen can help select patients who can benefit from antiviral therapy cessation and assess treatment efficacy. Novel viral and immunological biomarkers play a crucial role in the HBV functional cure program and may soon become a standard monitoring tool.