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.
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.