Author information

¹Evidence Synthesis, Evidera Ltd, London, UK.

²Evidence Synthesis, Evidera Inc, Montreal, Canada.

³Health Economics & Outcomes Research, Evidence, Value & Access, Vir Biotechnology Inc, San Francisco, CA, USA.

⁴Evidence, Value & Access, Vir Biotechology Inc, San Francisco, CA, USA.

⁵Biostatistics, Vir Biotechnology Inc, San Francisco, CA, USA.

⁶Clinical Research, Vir Biotechnology Inc, San Francisco, CA, USA.

⁷Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Abstract

Introduction: Hepatitis B Virus (HBV) infection can progress to chronic HBV (CHB) disease, thereby increasing the risk of severe forms of liver disease (i.e. liver cirrhosis and hepatocellular carcinoma) and resulting in a high global burden of morbidity, mortality, and health-care utilization.

Areas covered: We discuss how future therapeutic strategies and treatment guidelines may address the large unmet medical needs among patients with CHB.

Expert opinion: Complexity and a lack of consensus in current CHB treatment guidelines may limit their effective implementation. To minimize poor outcomes in patients not currently receiving treatment (including immune-tolerant and inactive carriers), a simplified harmonized treatment approach is needed across guidelines. Current treatment recommendations focus on nucleot(s)ide analogs (NAs) and pegylated interferon (Peg-IFN), both of which have limitations. NAs provide clinical benefits, but treatment is prolonged and has little impact on functional cure rates. Peg-IFN offers the potential for functional cure but has notable safety and tolerability issues. A shift toward finite treatments with acceptable safety and tolerability profiles is needed.

Conclusion: The key to achieving World Health Organization targets for the global eradication of HBV involves enhanced diagnosis with new treatments and/or combinations of existing treatments alongside globally aligned and simplified treatment guidelines for untreated/inadequately treated populations.