Therapeutic Interventions in the Management of Hepatitis B Infection

Posted On Jul 18, 2022

Dr. Anurag Shetty

Consultant - Medical Gastroenterology

Manipal Hospitals - Mangalore

Therapeutic intervention for HBV infection

Hepatitis B virus (HBV) is one of the most serious public health concerns, posing a serious threat all over the world. Approximately 300 million people are suffering from chronic HBV infection. Hepatitis B virus (HBV) is the virus that is responsible for affecting the liver and is more commonly transmitted by infected syringes through transfusion of infected blood, unhygienic tattooing practices, unintentional contact with the blood infected with HBV, and unprotected sex. Patients affected by HBV infection are prolonged towards the risk of developing liver cirrhosis and hepatocellular carcinoma (HCC). Visit Manipal Hospital for Hepatitis B Infection treatment in Mangalore.

Types of HPV Infection

HBV infection is mainly chronic and acute.

Acute HBV infection

This refers to the period immediately following HBV infection, when people are usually found to be asymptomatic. Approximately 5%–40% of the individuals affected by acute HBV infection are observed with the common symptoms of jaundice, tummy pain, tiredness, nausea, and vomiting.

Chronic HBV infection

Patients affected by chronic HBV infection are more prone to the risk of developing major health issues. The common symptoms of chronic HBV infection include more tiredness, liver failure resulting in vomiting blood, confusion, and death.

Treatment approach for HBV infection

The major aim of treating HBV infection is to achieve an effective cure for the disease, which is designated by loss of hepatitis B surface antigen (HBsAg), mainly with the development of anti-HBs, resulting in undetectable HBV DNA in the serum, normalisation of liver enzymes, and improved liver histology after treatment cessation. The best known approach for treating HBV infection is still not clear. Hence, the issue needs to be resolved, implicating an appropriate therapeutic and clinical approach. Consult with our gastroenterologist about Therapeutic intervention for HBV infection.

The antiviral therapies have been used to reduce the risk of HBV infection as most of the infected people have developed a seropositive isotope for anti-hepatitis B core antigen (anti-HBc). Notwithstanding the control over HBV replication for a longer duration, the currently used isotopes are not capable of eradicating HBV among patients with chronic HBV infection.

Therapeutic intervention for HBV infection

The current therapeutic approach for the management of HBV infection utilises two classes of therapeutic agents which are approved for treating chronic HBV infection and are capable of interrupting and preventing undesirable development involving the nucleos(t)ide analogues (NAs) and pegylated interferon alpha (Peg-IFN-). The nucleos(t)ide analogues are the oral, second generation, reverse transcriptase inhibitors involving tenofovir disoproxil fumarate (TDF), entecavir, and the recently approved tenofovir alafenamide (TAF). They react by suppressing the DNA level of HBV and are often represented as preventing disease development to cirrhosis, reverse liver fibrosis, and even cirrhosis, and reducing, but not eliminating, the risk of hepatocellular carcinoma (HCC). The other nucleos(t)ide analogues have very little effect on the covalently closed circular DNA (cccDNA). The stable episomal form of the HBV genome, which has a very long half-life and can persist for decades in hepatocytes despite effective viral suppression, As a result, nucleostide analogues (NAs) do not induce loss of HBsAg but rather suppress the viral replication that requires prolonged treatment.

Pegylated interferon alpha (Peg-IFN-) is applicable only for a limited time interval as it acts on various phases of the HBV life cycle. This drug is sometimes difficult to tolerate among patients.

A total of seven licenced products have been approved by the FDA and made available for the treatment of HBV infection, which are illustrated below.

  • Interferon- α

  • Pegylated interferon-α

  • Lamivudine

  • Adefovir (dipivoxil)

  • Entecavir

  • Telbivudine

  • Tenofovir (disoproxil fumarate)

Dr. Anurag Shetty

Consultant - Medical Gastroenterology

Manipal Hospital, Mangalore