Akbar Sheikh Mohammad Fazle, Al Mahtab Mamun, Yoshida Osamu, Aguilar Julio, Gerardo Guillen Nieto, Hiasa Yoichi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan.
Miyakawa Memorial Research Foundation, Tokyo 107-0062, Japan.
Biomedicines. 2023 Jul 8;11(7):1944. doi: 10.3390/biomedicines11071944.
According to the World Health Organization (WHO), an estimated 296 million people are chronically infected with hepatitis B virus (HBV). Approximately 15-25% of these people develop complications such as advanced chronic liver diseases (ACLDs). Mortality due to HBV-related complications accounted for an estimated 882,000 deaths in 2019. Potent preventive vaccines have already restricted new HBV infections, and several drugs are available to treat chronic HBV infections. However, the positive impacts of these drugs have been recorded in only a few patients with chronic HBV infection. These drugs do not show long-term efficacy and cannot halt the progression to complications. Thus, more effective and evidence-based therapeutic strategies need to be urgently developed for patients with chronic HBV infection. CHB is a pathological entity induced by HBV that progresses due to impaired host immunity. This indicates the inherent limitations of antiviral-drug-based monotherapy for treating patients with chronic HBV infection. Additionally, commercially available antiviral drugs are not available to patients in developing and resource-constrained countries, posing a challenge to achieving the following WHO goal: "Elimination of Hepatitis by 2030". As such, this review aimed to provide insights regarding evidence-based and effective management strategies for chronic HBV infection.
根据世界卫生组织（WHO）的数据，估计有2.96亿人慢性感染乙型肝炎病毒（HBV）。其中约15%-25%的人会出现诸如晚期慢性肝病（ACLD）等并发症。2019年，HBV相关并发症导致的死亡人数估计为88.2万。强效预防性疫苗已经限制了新的HBV感染，并且有几种药物可用于治疗慢性HBV感染。然而，这些药物的积极影响仅在少数慢性HBV感染患者中得到记录。这些药物没有显示出长期疗效，也无法阻止病情发展为并发症。因此，迫切需要为慢性HBV感染患者制定更有效且基于证据的治疗策略。慢性乙型肝炎（CHB）是一种由HBV引起的病理实体，由于宿主免疫力受损而进展。这表明基于抗病毒药物的单一疗法在治疗慢性HBV感染患者方面存在固有的局限性。此外，发展中国家和资源有限国家的患者无法获得市售抗病毒药物，这对实现世界卫生组织的以下目标构成挑战：“到2030年消除肝炎”。因此，本综述旨在提供有关慢性HBV感染的基于证据的有效管理策略的见解。
