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Hepatitis: HELP
Articles from Washington, DC
Based on 365 articles published since 2010
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These are the 365 published articles about Hepatitis that originated from Washington, DC during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15
1 Guideline Update on the management and treatment of hepatitis C virus infection: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program Office. 2012

Yee, Helen S / Chang, Michael F / Pocha, Christine / Lim, Joseph / Ross, David / Morgan, Timothy R / Monto, Alexander / Anonymous1490724 / Anonymous1500724. ·Department of Veterans Affairs Hepatitis C Resource Center Program, Washington, DC, USA. ·Am J Gastroenterol · Pubmed #22525303.

ABSTRACT: Chronic hepatitis C virus (HCV) infection affects approximately 1.3 % of the United States population and 4 % of veterans who use Department of Veterans Affairs medical services. Chronic HCV is the primary cause of cirrhosis, hepatocellular carcinoma (HCC), and end-stage liver disease requiring liver transplantation in the United States. Management of chronic HCV is aimed at halting disease progression, preventing cirrhosis decompensation, reducing the risk of HCC, and treating extrahepatic complications of the infection. As part of a comprehensive HCV management strategy, peginterferon alfa and ribavirin, along with the addition of a hepatitis C protease inhibitor therapy for many genotype 1-infected patients, are the current standard of care. Antiviral therapy should be provided to those individuals who are clinically stable, have moderate liver disease or compensated cirrhosis, and are motivated to pursue therapy. Many patients have comorbid medical and psychiatric conditions, which may affect their adherence to antiviral therapy or worsen while on antiviral therapy. To optimally manage hepatitis C and associated comorbidities, patients benefit from multidisciplinary teams that can provide HCV-specific care and treatment. Sustained virologic response is associated with "cure" of chronic HCV, and results in improved liver disease outcomes and prolonged survival.

2 Editorial Puerto Rican Syndemics: Opiates, Overdoses, HIV, and the Hepatitis C Virus in a Context of Ongoing Crises. 2020

Gelpí-Acosta, Camila / Rodríguez-Díaz, Carlos E / Aponte-Meléndez, Yesenia / Abadie, Roberto. ·Camila Gelpí-Acosta is with the Center for Drug Use and HIV and HCV Research, New York University College of Global Public Health, New York, and the Department of Social Sciences, LaGuardia Community College, City University of New York (CUNY), Long Island City. Carlos E. Rodríguez-Díaz is with the Department of Prevention and Community Health, George Washington University-Milken Institute School of Public Health, Washington, DC. Yesenia Aponte-Meléndez is a PhD candidate at The New School for Social Research and a Project Director at the Graduate School of Public Health and Health Policy, CUNY. Roberto Abadie is with the Department of Sociology, University of Nebraska-Lincoln. ·Am J Public Health · Pubmed #31913678.

ABSTRACT: -- No abstract --

3 Editorial Challenges, Considerations, and Principles to Guide Trials of Combination Therapies for Chronic Hepatitis B Virus. 2019

Anderson, Ryan Taylor / Lim, Seng Gee / Mishra, Poonam / Josephson, Filip / Donaldson, Eric / Given, Bruce / Miller, Veronica. ·University of California, Berkeley, Washington, DC. · National University of Singapore, Singapore, Republic of Singapore. · US Food and Drug Administration, Silver Spring, Maryland. · Swedish Medical Products Agency, Uppsala, Sweden. · Arrowhead Pharmaceuticals, Inc., Pasadena, California. ·Gastroenterology · Pubmed #30529300.

ABSTRACT: -- No abstract --

4 Editorial Editorial: FibroTest to predict liver-related mortality in NAFLD. Should this change the diagnostic algorithm in NAFLD? 2018

Bush, Allison M / Torres, Dawn M. ·Walter Reed National Military Medical Center, Bethesda, Maryland. ·Aliment Pharmacol Ther · Pubmed #30488622.

ABSTRACT: -- No abstract --

5 Editorial Donor screening for hepatitis B: hepatitis B surface antigen-a belt, suspenders, and another belt? 2018

Katz, Louis M / Sayers, Merlyn. ·America's Blood Centers, Washington, DC. · University of Iowa Healthcare, Iowa City, Iowa. · Carter BloodCare. · University of Texas Southwestern, Dallas, Texas. ·Transfusion · Pubmed #30204949.

ABSTRACT: -- No abstract --

6 Editorial Highlights from the 24 2017

Crowell, Trevor A / Lyall, Hermione / Malatinkova, Eva / Bhagani, Sanjay / Hsu, Denise / Colby, Donn J / Polyak, Christina / Psomas, Christina / Hill, Andrew / Gathogo, Esther N / Trypsteen, Wim / Vandekerckhove, Linos / Kinloch, Sabine. ·US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA. · Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA. · Department of Paediatrics, Imperial College Healthcare NHS, London, UK. · HIV Cure Research Center, Department of Internal Medicine, Ghent University, Belgium. · Royal Free London NHS Trust and University College London, UK. · Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand. · SEARCH-Thailand, Bangkok, Thailand and Thai Red Cross AIDS Research Centre, Bangkok, Thailand. · Department of Infectious Diseases, University Hospital of Montpellier, France. · Institute of Human Genetics, Université de Montpellier, France. · Department of Translational Medicine, University of Liverpool, UK. ·J Virus Erad · Pubmed #28435696.

ABSTRACT: From the 13th to 16th February 2017, researchers from around the world convened for the 24th annual

7 Editorial Preventing HIV and Hepatitis Infections Among People Who Inject Drugs: Leveraging an Indiana Outbreak Response to Break the Impasse. 2017

Crowley, Jeffrey S / Millett, Gregorio A. ·O'Neill Institute for National and Global Health Law, Georgetown University, 600 New Jersey Avenue, Washington, DC, 20001, USA. jeffrey.crowley@law.georgetown.edu. · amfAR, the Foundation for AIDS Research, Washington, DC, USA. ·AIDS Behav · Pubmed #28220312.

ABSTRACT: Providing clean needles through syringe services programs (SSPs) prevents the spread of disease among people who inject drugs (PWID). The recent HIV outbreak in Scott County, Indiana was a wakeup call with particular significance because modeling suggests that Scott County is but one of many counties in the United States highly vulnerable to an HIV outbreak among PWID. It is a painful recognition that some policy makers ignored the evidence in support of SSPs when it was primarily blacks in inner cities that were affected, yet swung into action in the wake of Scott County where 99% of the cases were white. Too many Americans have been taught to shame and shun drug users (irrespective or race or ethnicity). Therefore, we need lessons that afford benefits to all communities. We need to understand what made opinion leaders change their views and then change more hearts and minds before, not after the next outbreak.

8 Editorial Oxidative Stress and Inflammation in Hepatic Diseases: Current and Future Therapy. 2017

Reyes-Gordillo, Karina / Shah, Ruchi / Muriel, Pablo. ·Lipid Research Laboratory, VA Medical Center, 50 Irving Street NW, Washington, DC 20422, USA; Department of Biochemistry and Molecular Medicine, The George Washington University, 2300 I Street NW, Suite 530, Washington, DC 20037, USA. · Laboratory of Experimental Hepatology, Department of Pharmacology, Cinvestav-IPN, Av. Instituto Politécnico Nacional 2508, Col. San Pedro Zacatenco, 07360, Apartado Postal 14-740, 07000 México, DF, Mexico. ·Oxid Med Cell Longev · Pubmed #28203318.

ABSTRACT: -- No abstract --

9 Editorial A Convenient Truth: Cost of Medications Need Not Be a Barrier to Hepatitis B Treatment. 2016

Barnhart, Matthew. ·Global Health, Science and Practice, Associate Editor, Washington, DC, USA. ·Glob Health Sci Pract · Pubmed #27353613.

ABSTRACT: -- No abstract --

10 Review Alcoholic-Hepatitis, Links to Brain and Microbiome: Mechanisms, Clinical and Experimental Research. 2020

Neuman, Manuela G / Seitz, Helmut Karl / French, Samuel W / Malnick, Stephen / Tsukamoto, Heidekazu / Cohen, Lawrence B / Hoffman, Paula / Tabakoff, Boris / Fasullo, Michael / Nagy, Laura E / Tuma, Pamela L / Schnabl, Bernd / Mueller, Sebastian / Groebner, Jennifer L / Barbara, French A / Yue, Jia / Nikko, Afifiyan / Alejandro, Mendoza / Brittany, Tillman / Edward, Vitocruz / Harrall, Kylie / Saba, Laura / Mihai, Opris. ·In Vitro Drug Safety and Biotechnology, Toronto, ON, M5G 1L5, Canada. · Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON, M5G 1L5, Canada. · Department of Medicine, Centre of Alcohol Research, University of Heidelberg, Salem Medical Centre, 337374 Heidelberg, Germany. · Department of Pathology, Harbor-UCLA Medical Center and Los Angeles BioMedical Institute, Torrance, CA Harbor-UCLA Medical Center, Torrance, CA 90509, USA. · Department Internal Medicine C, Kaplan Medical Centre and Hebrew University of Jerusalem, Rehovot 76100, Israel. · Southern California Research Center for ALPD and Cirrhosis, Department of Pathology, Keck School of Medicine of the University of Southern California, CA 90089-5311, USA. · Department of Veterans; Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA. · Division of Gastroenterology, Sunnybrook Health Sciences Centre, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M4N 3M5, Canada. · Department of Pharmacology, University of Colorado School of Medicine, Aurora, CO 80045-0511, USA. · College of Nanoscale Science and Engineering, SUNY Polytechnic Institute, Albany, NY 12205, USA. · Departments of Pathobiology and Gastroenterology, Center for Liver Disease Research, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. · Department of Biology, The Catholic University of America, Washington, DC 20064, USA. · Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA. · Department Family Medicine Clinic CAR, Bucharest, Romania. ·Biomedicines · Pubmed #32197424.

ABSTRACT: The following review article presents clinical and experimental features of alcohol-induced liver disease (ALD). Basic aspects of alcohol metabolism leading to the development of liver hepatotoxicity are discussed. ALD includes fatty liver, acute alcoholic hepatitis with or without liver failure, alcoholic steatohepatitis (ASH) leading to fibrosis and cirrhosis, and hepatocellular cancer (HCC). ALD is fully attributable to alcohol consumption. However, only 10-20% of heavy drinkers (persons consuming more than 40 g of ethanol/day) develop clinical ALD. Moreover, there is a link between behaviour and environmental factors that determine the amount of alcohol misuse and their liver disease. The range of clinical presentation varies from reversible alcoholic hepatic steatosis to cirrhosis, hepatic failure, and hepatocellular carcinoma. We aimed to (1) describe the clinico-pathology of ALD, (2) examine the role of immune responses in the development of alcoholic hepatitis (ASH), (3) propose diagnostic markers of ASH, (4) analyze the experimental models of ALD, (5) study the role of alcohol in changing the microbiota, and (6) articulate how findings in the liver and/or intestine influence the brain (and/or vice versa) on ASH; (7) identify pathways in alcohol-induced organ damage and (8) to target new innovative experimental concepts modeling the experimental approaches. The present review includes evidence recognizing the key toxic role of alcohol in ALD severity. Cytochrome p450 CYP2E1 activation may change the severity of ASH. The microbiota is a key element in immune responses, being an inducer of proinflammatory T helper 17 cells and regulatory T cells in the intestine. Alcohol consumption changes the intestinal microbiota and influences liver steatosis and liver inflammation. Knowing how to exploit the microbiome to modulate the immune system might lead to a new form of personalized medicine in ALF and ASH.

11 Review FIB-4 stage of liver fibrosis is associated with incident heart failure with preserved, but not reduced, ejection fraction among people with and without HIV or hepatitis C. 2020

So-Armah, Kaku A / Lim, Joseph K / Lo Re, Vincent / Tate, Janet P / Chang, Chung-Chou H / Butt, Adeel A / Gibert, Cynthia L / Rimland, David / Marconi, Vincent C / Goetz, Matthew Bidwell / Ramachandran, Vasan / Brittain, Evan / Long, Michelle / Nguyen, Kim-Lien / Rodriguez-Barradas, Maria C / Budoff, Matthew J / Tindle, Hilary A / Samet, Jeffrey H / Justice, Amy C / Freiberg, Matthew S / Anonymous2901165. ·Boston University School of Medicine, Boston, MA, USA. Electronic address: kaku@bu.edu. · Yale University School of Medicine, New Haven, CT, USA. Electronic address: joseph.lim@yale.edu. · Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: vincentl@pennmedicine.upenn.edu. · Yale University School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA. Electronic address: Janet.Tate2@va.gov. · University of Pittsburgh Schools of Medicine and Public Health, Pittsburgh, PA, USA. Electronic address: changjh@upmc.edu. · Weill Cornell Medical College, NY, USA; VA Pittsburgh Healthcare System, PA, USA; Hamad Healthcare Quality Institute, Hamad Medical Corporation, Doha, Qatar. Electronic address: aab2005@qatar-med.cornell.edu. · VA Medical Center & George Washington University School of Medicine and Public Health, Washington, DC, USA. Electronic address: Cynthia.Gibert@va.gov. · Atlanta VA Medical Center & Emory University School of Medicine, Atlanta, GA, USA. · Atlanta VA Medical Center; Emory University School of Medicine and Rollins School of Public Health, Atlanta, GA, USA. Electronic address: vcmarco@emory.edu. · VA Greater Los Angeles Healthcare System and the David Geffen School of Medicine at the University of California, Los Angeles, CA, USA. Electronic address: Matthew.Goetz@va.gov. · Boston University School of Medicine, Boston, MA, USA. Electronic address: vasan@bu.edu. · Vanderbilt University School of Medicine, Nashville, TN, USA. Electronic address: evan.brittain@vumc.org. · Boston University School of Medicine, Boston, MA, USA. Electronic address: mtlong@bu.edu. · David Geffen School of Medicine at the University of California, Los Angeles, CA, USA. Electronic address: kimliennguyen@mednet.ucla.edu. · Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA. Electronic address: Maria.Rodriguez-Barradas2@va.gov. · Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, CA, USA. Electronic address: mbudoff@labiomed.org. · Vanderbilt University School of Medicine, Nashville, TN, USA. Electronic address: hilary.tindle@vanderbilt.edu. · Boston University Schools of Medicine and Public Health, Boston Medical Center, Boston, MA, USA. Electronic address: jsamet@bu.edu. · VA Connecticut Healthcare System, West Haven, CT, USA; Yale University Schools of Medicine and Public Health, New Haven, CT, USA. Electronic address: Amy.Justice2@va.gov. · Vanderbilt University School of Medicine, Nashville, TN, USA; Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN, USA. Electronic address: matthew.s.freiberg@vanderbilt.edu. ·Prog Cardiovasc Dis · Pubmed #32068085.

ABSTRACT: BACKGROUND: Liver fibrosis, is independently associated with incident heart failure (HF). Investigating the association between liver fibrosis and type of HF, specifically HF with reduced ejection fraction (EF; HFrEF) or HF with preserved ejection fraction (HFpEF), may provide mechanistic insight into this association. We sought to determine the association between liver fibrosis score (FIB-4) and type of HF, and to assess whether HIV or hepatitis C status modified this association. METHODS: We included patients alive on or after 4/1/2003 from the Veterans Aging Cohort Study. We followed patients without prevalent cardiovascular disease until their first HF event, death, last clinic visit, or 9/30/2015. We defined liver fibrosis as: likely advanced fibrosis (FIB-4 > 3.25), indeterminate (FIB-4 range 1.45-3.25), unlikely advanced fibrosis (FIB-4 < 1.45). Primary outcomes were HFrEF and HFpEF (defined using ICD-9 diagnoses for HF, and EF extracted from electronic medical records using natural language processing). Cox proportional hazards models were adjusted for potential confounders and used to estimate hazard ratios (HR). RESULTS: Among 108,708 predominantly male (96%) participants mean age was 49 years. Likely advanced fibrosis was present in 4% at baseline and was associated with an increased risk of HFpEF [HR (95% confidence interval)] [1.70 (1.3-2.3)]; and non-significantly with HFrEF [1.20 (0.9-1.7)]. These associations were not modified by HIV or hepatitis C status. CONCLUSION: Likely advanced fibrosis was independently associated with incident HFpEF but not HFrEF. This suggests that risk factors and/or mechanisms for liver fibrosis may have greater overlap with those for HFpEF than HFrEF.

12 Review Hepatotoxicity induced by immune checkpoint inhibitors: a comprehensive review including current and alternative management strategies. 2019

Jennings, Joseph J / Mandaliya, Rohan / Nakshabandi, Ahmad / Lewis, James H. ·a Department of Medicine, Division of Gastroenterology and Hepatology , MedStar Georgetown University Hospital , Washington , DC , USA. · b Department of Internal Medicine , Mercy Hospital and Medical Center , Chicago , IL , USA. ·Expert Opin Drug Metab Toxicol · Pubmed #30677306.

ABSTRACT: INTRODUCTION: Immune checkpoint inhibitors (ICIs) block cytotoxic T lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1)/PD ligand 1 (PD-L1) receptors that control antitumor activities of lymphocytes. While highly efficacious, these drugs have been associated with several immune-related adverse events (irAEs) due to the disruption of self-tolerance. Immune-mediated hepatitis (IMH) usually presents as mild elevations of liver enzymes though it can rarely be associated with life-threatening hepatic injury. Areas covered: A comprehensive review was performed to define the clinicopathologic forms of liver injury associated with ICIs, comparing the various ICI classes as well as comparing this form of IMH with idiopathic autoimmune hepatitis and drug-induced autoimmune hepatitis. Liver biopsy has proven very useful in selected patients. A specific form of fibrin ring granulomatous hepatitis appears to be associated with IMH. The current societal treatment algorithms and emerging data were reviewed to determine when to utilize corticosteroids. Expert opinion: Monitoring for severe ICI-IMH is recommended although acute liver failure remains rare. Most patients with grade 3-4 hepatotoxicity respond to corticosteroids, but a subset of patients with mild hepatitis on liver biopsy resolve without steroids and need to be carefully selected in concert with the consultation of a hepatologist.

13 Review Five Questions Concerning Managing Hepatitis C in the Justice System: Finding Practical Solutions for Hepatitis C Virus Elimination. 2018

Spaulding, Anne C / Adee, Madeline G / Lawrence, Robert T / Chhatwal, Jagpreet / von Oehsen, William. ·Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road Room 3033, Atlanta, GA 30322, USA; Department of Medicine, Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA 30310, USA. Electronic address: aspauld@emory.edu. · Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road Room 3033, Atlanta, GA 30322, USA. · Alaska Department of Corrections, 550 West 7th Avenue, Suite 1860, Anchorage, AK 99501, USA. · Institute for Technology Assessment, Massachusetts General Hospital, Harvard University, 101 Merrimac Street, Floor 10, Boston, MA 02114, USA. · Powers Pyles Sutter & Verville PC, 1501 M Street Northwest, Seventh Floor, Washington, DC 20005-1700, USA. ·Infect Dis Clin North Am · Pubmed #29778259.

ABSTRACT: An estimated 30% of Americans with hepatitis C virus (HCV) pass through a jail or prison annually. One in 7 incarcerated persons is viremic. Screening and treatment is cost-effective and beneficial to society as a whole. Yet at current (2018) levels of funding for HCV management, prisons are not aggressively seeking cases; few incarcerated persons with HCV actually receive treatment. This article explores barriers to screening for and treating hepatitis C in state prisons, and ways that states may overcome these barriers, such as nominal pricing. While high prices for direct-acting antivirals discourage treatment, potential strategies exist to lower prices.

14 Review Hepatitis C Care in the Department of Veterans Affairs: Building a Foundation for Success. 2018

Belperio, Pamela S / Chartier, Maggie / Gonzalez, Rachel I / Park, Angela M / Ross, David B / Morgan, Tim R / Backus, Lisa I. ·Patient Care Services/Population Health, Department of Veterans Affairs, Palo Alto Health Care System, 3801 Miranda Avenue (132), Palo Alto, CA 94304, USA. · HIV, Hepatitis and Related Conditions, Office of Specialty Care Services (10P11I), Department of Veterans Affairs, 810 Vermont Avenue, Washington, DC 20420, USA. · Research Health Care Group, VA Long Beach Health Care System, 5901 East 7th Street, Long Beach, CA 90822, USA. · New England Veterans Engineering Resource Center, Department of Veterans Affairs, 150 South Huntingtin Avenue, Boston, MA 02130, USA. · Division of Gastroenterology, VA Long Beach Health Care System, 5901 East 7th Street, Long Beach, CA 90822, USA. · Patient Care Services/Population Health, Department of Veterans Affairs, Palo Alto Health Care System, 3801 Miranda Avenue (132), Palo Alto, CA 94304, USA. Electronic address: Lisa.Backus@va.gov. ·Infect Dis Clin North Am · Pubmed #29778256.

ABSTRACT: The Department of Veterans Affairs (VA) has made significant progress in treating hepatitis C virus, experiencing more than a 75% reduction in veterans remaining to be treated since the availability of oral direct-acting antivirals. Hepatitis C Innovation Teams use lean process improvement and system redesign, resulting in practice models that address gaps in care. The key to success is creative improvements in veteran access to providers, including expanded use of nonphysician providers, video telehealth, and electronic technologies. Population health management tools monitor and identify trends in care, helping the VA tailor care and address barriers.

15 Review Ocular Manifestations of Mosquito-Transmitted Diseases. 2018

Karesh, James W / Mazzoli, Robert A / Heintz, Shannon K. ·The Vision Center of Excellence, Walter Reed National Military Medical Center, 8960 Brown Drive, Building 2, 1st Floor, Room 1403-A, Bethesda, MD 20889-5629. · The Vision Center of Excellence, Walter Reed National Military Medical Center, 8960 Brown Drive, Building 2, 1 st Floor, Room 1403-A, Bethesda, MD 20889-5629. · Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431. ·Mil Med · Pubmed #29635625.

ABSTRACT: Of the 3,548 known mosquito species, about 100 transmit human diseases. Mosquitoes are distributed globally throughout tropical and temperate regions where standing water sources are available for egg laying and the maturation of larva. Female mosquitoes require blood meals for egg production. This is the main pathway for disease transmission. Mosquitoes carry several pathogenic organisms responsible for significant ocular pathology and vision loss including West Nile, Rift Valley, chikungunya, dengue viruses, various encephalitis viruses, malarial parasites, Francisella tularensis, microfilarial parasites, including Dirofilaria, Wuchereria, and Brugia spp., and human botfly larvae. Health care providers may not be familiar with many of these mosquito-transmitted diseases or their associated ocular findings delaying diagnosis, treatment, and recovery of visual function. This article aims to provide an overview of the ocular manifestations associated with mosquito-transmitted diseases.

16 Review Modulators of innate immunity as novel therapeutics for treatment of chronic hepatitis B. 2018

Suslov, Aleksei / Wieland, Stefan / Menne, Stephan. ·Department of Biomedicine, University Hospital Basel, University of Basel, Basel CH-4031, Switzerland. · Department of Biomedicine, University Hospital Basel, University of Basel, Basel CH-4031, Switzerland. Electronic address: stefan.wieland@unibas.ch. · Department of Microbiology & Immunology, Georgetown University Medical Center, Washington, DC 20057, United States. Electronic address: Stephan.Menne@georgetown.edu. ·Curr Opin Virol · Pubmed #29444493.

ABSTRACT: The first line defense mechanisms against viral infection are mediated by the innate immune system. Viral components are detected by infected cells and/or innate immune cells that express different sensory receptors. They in turn mediate induction of direct antiviral mechanisms and further modulation of innate and adaptive immune responses. For evading the innate system, most viruses have evolved efficient mechanisms to block sensing and/or antiviral functions of the innate response. Interestingly, hepatitis B virus (HBV) seems to act like a stealth virus that escapes cell intrinsic antiviral mechanisms through avoiding recognition by the innate system rather than blocking its effector functions. In line with this concept, agonistic activation of innate immunity has emerged as a promising novel anti-HBV therapy approach with several compounds having advanced to the clinical stage.

17 Review Report from the International Conference on Viral Hepatitis - 2017. 2018

Soriano, Vicente / Young, Benjamin / Reau, Nancy. ·Infectious Diseases Unit, La Paz University Hospital, Madrid, Spain. · International Association of Providers of AIDS Care, Washington, DC, USA. · Liver Unit, Rush University Medical Center, Chicago, IL, USA. ·AIDS Rev · Pubmed #29369303.

ABSTRACT: The International Conference on Viral Hepatitis 2017 brought exciting news on the treatment of viral hepatitis. The most recent estimates of the burden for hepatitis B virus and hepatitis C virus (HCV) infections were presented. The current gaps and prospects for regional and global eradication of viral hepatitis were discussed on the light of the WHO roadmap until 2030. Debates focused on hepatitis C and expectations using the new approved HCV pan-genotypic, once daily, oral direct-acting antivirals (DAAs), glecaprevir-pibrentasvir, and sofosbuvir-velpatasvir-voxilaprevir. The management of difficult-to-cure HCV patients included individuals who had failed prior DAAs, people who inject drugs, patients with decompensated cirrhosis, or renal insufficiency. Special patient populations such as children, pregnant women, persons with acute hepatitis C, or HIV coinfection were addressed separately. The use of HCV treatment as prevention was subject to debate, balancing the benefits on halting transmission and the risk for HCV reinfections and high medication costs. Complementary efforts on behavioral interventions and harm reduction programs were highlighted. Data from both clinical trials and real-world experience (i.e., from the US Veterans) were compared. Further debates addressed hepatic conditions that may alter the management and outcome of viral hepatitis, such as hepatitis B reactivation, non-alcoholic fatty liver disease, liver transplantation, and hepatocellular carcinoma. Finally, the recent data on often neglected hepatitis D and E virus infections were reviewed.

18 Review Pathogen reduction and blood transfusion safety in Africa: strengths, limitations and challenges of implementation in low-resource settings. 2018

Ware, A D / Jacquot, C / Tobian, A A R / Gehrie, E A / Ness, P M / Bloch, E M. ·Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. · Children's National Health System and George Washington University School of Medicine and Health Sciences, Washington, DC, USA. ·Vox Sang · Pubmed #29193128.

ABSTRACT: Transfusion-transmitted infection risk remains an enduring challenge to blood safety in Africa. A high background incidence and prevalence of the major transfusion-transmitted infections (TTIs), dependence on high-risk donors to meet demand, suboptimal testing and quality assurance collectively contribute to the increased risk. With few exceptions, donor testing is confined to serological evaluation of human immunodeficiency virus (HIV), hepatitis B and C (HBV and HCV) and syphilis. Barriers to implementation of broader molecular methods include cost, limited infrastructure and lack of technical expertise. Pathogen reduction (PR), a term used to describe a variety of methods (e.g. solvent detergent treatment or photochemical activation) that may be applied to blood following collection, offers the means to diminish the infectious potential of multiple pathogens simultaneously. This is effective against different classes of pathogen, including the major TTIs where laboratory screening is already implemented (e.g. HIV, HBV and HCV) as well pathogens that are widely endemic yet remain unaddressed (e.g. malaria, bacterial contamination). We sought to review the available and emerging PR techniques and their potential application to resource-constrained parts of Africa, focusing on the advantages and disadvantages of such technologies. PR has been slow to be adopted even in high-income countries, primarily given the high costs of use. Logistical considerations, particularly in low-resourced parts of Africa, also raise concerns about practicality. Nonetheless, PR offers a rational, innovative strategy to contend with TTIs; technologies in development may well present a viable complement or even alternative to targeted screening in the future.

19 Review Mutation and recombination in pathogen evolution: Relevance, methods and controversies. 2018

Arenas, Miguel / Araujo, Natalia M / Branco, Catarina / Castelhano, Nadine / Castro-Nallar, Eduardo / Pérez-Losada, Marcos. ·Department of Biochemistry, Genetics and Immunology, University of Vigo, Vigo, Spain; Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal; Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal. Electronic address: marenas@uvigo.es. · Laboratory of Molecular Virology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil. Electronic address: nmaraujo@ioc.fiocruz.br. · Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal; Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal. Electronic address: cbranco@ipatimup.pt. · Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal; Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal. Electronic address: nadines@ipatimup.pt. · Universidad Andrés Bello, Center for Bioinformatics and Integrative Biology, Facultad de Ciencias Biológicas, Santiago, Chile. Electronic address: eduardo.castro@unab.cl. · Computational Biology Institute, Milken Institute School of Public Health, George Washington University, Ashburn, VA 20147, Washington, DC, United States; CIBIO-InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus Agrário de Vairão, Vairão 4485-661, Portugal. Electronic address: mlosada@gwu.edu. ·Infect Genet Evol · Pubmed #28951202.

ABSTRACT: Mutation and recombination drive the evolution of most pathogens by generating the genetic variants upon which selection operates. Those variants can, for example, confer resistance to host immune systems and drug therapies or lead to epidemic outbreaks. Given their importance, diverse evolutionary studies have investigated the abundance and consequences of mutation and recombination in pathogen populations. However, some controversies persist regarding the contribution of each evolutionary force to the development of particular phenotypic observations (e.g., drug resistance). In this study, we revise the importance of mutation and recombination in the evolution of pathogens at both intra-host and inter-host levels. We also describe state-of-the-art analytical methodologies to detect and quantify these two evolutionary forces, including biases that are often ignored in evolutionary studies. Finally, we present some of our former studies involving pathogenic taxa where mutation and recombination played crucial roles in the recovery of pathogenic fitness, the generation of interspecific genetic diversity, or the design of centralized vaccines. This review also illustrates several common controversies and pitfalls in the analysis and in the evaluation and interpretation of mutation and recombination outcomes.

20 Review Risk of Cardiovascular Disease Due to Chronic Hepatitis C Infection: A Review. 2017

Babiker, Ahmed / Jeudy, Jean / Kligerman, Seth / Khambaty, Miriam / Shah, Anoop / Bagchi, Shashwatee. ·Providence Hospital, Washington, DC, USA. · Department of Radiology, University of Maryland School of Medicine, Baltimore, MD, USA. · Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD, USA. · Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. · Division of Cardiology, University of Edinburgh, Little France, Edinburgh. ·J Clin Transl Hepatol · Pubmed #29226101.

ABSTRACT: Hepatitis C (HCV) infection has an estimated global prevalence of 2.5%, causing chronic liver disease in 170 million people worldwide. Recent data has identified HCV infection as a risk factor for subclinical and clinical cardiovascular disease (CVD), but these data have been mixed and whether HCV is an independent risk factor for development of CVD remains controversial. In this review, we present the literature regarding the association of HCV with subclinical and clinical CVD and the possible underlying mechanisms leading to increased CVD among those infected with HCV. HCV infection leads to increased CVD via direct and indirect mechanisms with chronic inflammation, endothelial dysfunction and direct invasion of the arterial wall cited as possible mechanisms. Our review showed that HCV infection, particularly chronic HCV infection, appears to lead to increased subclinical CVD most consistently and potentially also to increased clinical CVD outcomes, leading to increased morbidity and mortality. Furthermore, the majority of studies evaluating the impact of HCV therapy on CVD morbidity and mortality showed an improvement in subclinical and clinical CVD endpoints in patients who were successfully treated and achieved sustained viral suppression. These results are of particular interest following the development of new direct antiviral agents which have made HCV eradication simple and feasible for many more patients globally, and in doing so may possibly reduce CVD morbidity and mortality in those with chronic HCV infection.

21 Review Historical epidemiology of hepatitis C virus in select countries-volume 4. 2017

Maaroufi, A / Vince, A / Himatt, S M / Mohamed, R / Fung, J / Opare-Sem, O / Workneh, A / Njouom, R / Al Ghazzawi, I / Abdulla, M / Kaliaskarova, K S / Owusu-Ofori, S / Abdelmageed, M K / Adda, D / Akin, O / Al Baqali, A / Al Dweik, N / Al Ejji, K / Al Kaabi, S / Al Naamani, K / Al Qamish, J / Al Sadadi, M / Al Salman, J / AlBadri, M / Al-Busafi, S A / Al-Romaihi, H E / Ampofo, W / Antonov, K / Anyaike, C / Arome, F / Bane, A / Blach, S / Borodo, M M / Brandon, S M / Bright, B / Butt, M T / Cardenas, I / Chan, H L Y / Chen, C J / Chen, D S / Chen, P J / Chien, R N / Chuang, W L / Cuellar, D / Derbala, M / Elbardiny, A A / Estes, C / Farag, E / Gamkrelidze, I / Garcia, V / Genov, J / Ghandour, Z / Ghuloom, M / Gomez, B / Gunter, J / Habeeb, J / Hajelssedig, O / Hamoudi, W / Hrstic, I / Hu, C C / Huang, C F / Hui, Y T / Jahis, R / Jelev, D / John, A K / Kamel, Y / Kao, J H / Khamis, J / Khattabi, H / Khoudri, I / Konysbekova, A / Kotzev, I / Lai, M S / Lao, W C / Layden, J / Lee, M H / Lesi, O / Li, M / Lo, A / Loo, C K / Lukšić, B / Malu, A O / Mateva, L / Mitova, R / Morović, M / Murphy, K / Mustapha, B / Nde, H / Nersesov, A / Ngige, E / Njoya, O / Nonković, D / Obekpa, S / Oguche, S / Okolo, E E / Omede, O / Omuemu, C / Ondoa, P / Phillips, R O / Prokopenko, Y N / Razavi, H / Razavi-Shearer, D / Redae, B / Reic, T / Rinke de Wit, T / Rios, C / Robbins, S / Roberts, L R / Sanad, S J / Schmelzer, J D / Sharma, M / Simonova, M / Su, T H / Sultan, K / Tan, S S / Tchernev, K / Tsang, O T Y / Tsang, S / Tzeuton, C / Ugoeze, S / Uzochukwu, B / Vi, R / Wani, H U / Wong, V W S / Yacoub, R / Yesmembetov, K I / Youbi, M / Yuen, M F / Razavi-Shearer, K. ·National Institute of Health Administration, Rabat, Morocco. · Medical School University of Zagreb, University Hospital of Infectious Diseases Zagreb, Zagreb, Croatia. · Ministry of Public Health Qatar, Doha, Qatar. · University of Malaya Medical Centre, Kuala Lumpur, Malaysia. · Department of Medicine, The University of Hong Kong, Hong Kong, SAR, China. · Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. · Non-Communicable Diseases Programme, World Health Organization, Addis Ababa, Ethiopia. · Federal Ministry of Health, Addis Ababa, Ethiopia. · Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon. · GI and Hepatology Department, Jordan Royal Medical Services, Amman, Jordan. · Salmaniya Medical Complex, Manama, Bahrain. · Ministry of Healthcare and Social Development of the Republic of Kazakhstan, Astana, Kazakhstan. · Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan. · Komfo Anokye Teaching Hospital, Kumasi, Ghana. · Hamad Medical Corporation, Doha, Qatar. · Civil Society Network on Hepatitis, Abuja, Nigeria. · Chagro-Care Trust (CCT), Jalingo, Nigeria. · Federal Ministry of Health, Abuja, Nigeria. · Al Kindi Specialised Hospital, Manama, Bahrain. · Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar. · Division of Gastroenterology and Hepatology, Department of Medicine, Armed Forces Hospital, Muscat, Oman. · Gastroenterolgy Clinic, IBN Al-Nafees Hospital, Manama, Bahrain. · Division of Gastroenterology, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman. · Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana. · University Hospital "St. Ivan Rilski", Sofia, Bulgaria. · Advocacy for the Prevention of Hepatitis in Nigeria, Jos, Nigeria. · Gastroenterology and Hepatology, Addis Ababa University Medical School, Addis Ababa, Ethiopia. · Ethiopian Gastroenterological Association, Addis Ababa, Ethiopia. · Center for Disease Analysis (CDA), Lafayette, CO, USA. · Aminu Kano Teaching Hospital, Kano, Nigeria. · Bayero University, Kano, Nigeria. · LiveWell Initiative (LWI), Lagos, Nigeria. · Communicable Diseases Division, Ministry of Health and Social Protection, Bogota, Colombia. · Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China. · Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, SAR, China. · Academia Sinica, Taipei, Taiwan. · Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. · National Taiwan University, Taipei, Taiwan. · Liver Research Unit, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan. · Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan. · Department of Epidemiology and Demography, Ministry of Health and Social Protection, Bogota, Colombia. · Ministry of Public Health, Santo Domingo, Dominican Republic. · University Hospital "Queen Joanna", Sofia, Bulgaria. · BDF Hospital, Royal Medical Services, Riffa, Bahrain. · Pan American Health Organization, Washington, DC, USA. · Department of Gastroenterology & Hepatology, Al Bashir Hospital, Amman, Jordan. · Jordan Ministry of Health, Amman, Jordan. · General Hospital Pula, Pula, Croatia. · Department of Medicine, Queen Elizabeth Hospital, Hong Kong, SAR, China. · Disease Control Division, Ministry of Health, Putrajaya, Malaysia. · Department of Medicine, Miniya University, Minya, Egypt. · Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan. · Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt. · Republican Diagnostic Center, Astana, Kazakhstan. · University Medical Center, Astana, Kazakhstan. · University Hospital "St. Marina", Varna, Bulgaria. · Department of Medicine, North District Hospital, Hong Kong, SAR, China. · Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, SAR, China. · Department of Public Health Sciences, Loyola University Chicago, Chicago, IL, USA. · Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. · University of Lagos, Lagos, Nigeria. · Lagos University Teaching Hospital, Lagos, Nigeria. · Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, SAR, China. · Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, SAR, China. · Clinical Department of Infectious Diseases, Split University Hospital and Split University Medical School, Split, Croatia. · Benue State University Teaching Hospital, Makurdi, Nigeria. · Department of Infectious Diseases, Zadar General Hospital, Zadar, Croatia. · IBN SINA Hospital, Rabat, Morocco. · National Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan. · Research Laboratory on Viral Hepatitis & Health Communication, Faculty of Medicine, University of Yaoundé, Yaoundé, Cameroon. · Department of Epidemiology, Institute of Public Health, County of Dalmatia, Split, Croatia. · Department of Pediatrics, University of Jos, Jos, Nigeria. · Department of Medicine, University of Jos, Jos, Nigeria. · Jos University Teaching Hospital, Jos, Nigeria. · Beacon Youth Initiative, Lafia, Nigeria. · University of Benin, Benin City, Nigeria. · Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands. · African Society of Laboratory Medicine, Addis Ababa, Ethiopia. · St. Paul's Hospital Millennium College, Addis Ababa, Ethiopia. · European Liver Patients Association, Sint-Truiden, Belgium. · PharmAccess Foundation, Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · Department of Health Promotion and Disease Prevention, Ministry of Health and Social Protection, Bogota, Colombia. · Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. · Clinic of Gastroenterology, Military Medical Academy, Sofia, Bulgaria. · Department of Hepatology, Selayang Hospital, Selangor, Malaysia. · "Sofiamed" Hospital, Sofia, Bulgaria. · Department of Medicine and Geriatrics, Princess Margaret Hospital Authority, Hong Kong, SAR, China. · Department of Medicine, Tseung Kwan O Hospital, Hong Kong, SAR, China. · Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon. · Federal Medical Centre, Jalingo, Nigeria. · Institute of Public Health, University of Nigeria, Nsukka, Nigeria. · International HepatoTransplant Group, Astana, Kazakhstan. · State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, SAR, China. · National Scientific Center of Oncology and Transplantology, Astana, Kazakhstan. · Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR, China. ·J Viral Hepat · Pubmed #29105285.

ABSTRACT: Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis C.

22 Review Isolated anti-HBc: The Relevance of Hepatitis B Core Antibody-A Review of New Issues. 2017

Wu, Tiffany / Kwok, Ryan M / Tran, Tram T. ·Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA. · Division of Gastroenterology and Hepatology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA. · Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA. ·Am J Gastroenterol · Pubmed #29087395.

ABSTRACT: Hepatitis B core antibody (anti-HBc) is considered the most sensitive serological marker for history of hepatitis B virus (HBV) infection. In a subset of anti-HBc carriers, anti-HBc is present in the absence of hepatitis B surface antigen and hepatitis B surface antibody-a serological pattern known as "isolated anti-HBc" (IAHBc). IAHBc has been of clinical interest over the past several years, with growing data to suggest its role as a serological marker for occult HBV infection (OBI). This article reviews the clinical significance and association of IAHBc with hepatitis C virus (HCV) co-infection, risk of HBV reactivation during direct-acting antiviral therapy for HCV as well as immune suppression, and development of hepatocellular carcinoma (HCC). Hepatitis B core-related antigen is also highlighted as an emerging laboratory assay that may identify OBI and predict HCC development in non-cirrhotic patients receiving nucleoside/nucleotide analog therapy.

23 Review Epigenetic regulation of hepatitis B virus covalently closed circular DNA: Implications for epigenetic therapy against chronic hepatitis B. 2017

Hong, Xupeng / Kim, Elena S / Guo, Haitao. ·Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC. · Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN. ·Hepatology · Pubmed #28833361.

ABSTRACT: Hepatitis B virus (HBV) infection represents a significant public health burden worldwide. Although current therapeutics manage to control the disease progression, lifelong treatment and surveillance are required because drug resistance develops during treatment and reactivations frequently occur following medication cessation. Thus, the occurrence of hepatocellular carcinoma is decreased, but not eliminated. One major reason for failure of HBV treatment is the inability to eradicate or inactivate the viral covalently closed circular DNA (cccDNA), which is a stable episomal form of the viral genome decorated with host histones and nonhistone proteins. Accumulating evidence suggests that epigenetic modifications of cccDNA contribute to viral replication and the outcome of chronic HBV infection. Here, we summarize current progress on HBV epigenetics research and the therapeutic implications for chronic HBV infection by learning from the epigenetic therapies for cancer and other viral diseases, which may open a new venue to cure chronic hepatitis B. (Hepatology 2017;66:2066-2077).

24 Review Economic Burden of Hepatitis C Infection. 2017

Stepanova, Maria / Younossi, Zobair M. ·Center for Outcomes Research in Liver Diseases, 2411 I Street NW, Washington, DC 20037, USA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, 3300 Gallows Road, Falls Church, VA 22042, USA. · Center for Outcomes Research in Liver Diseases, 2411 I Street NW, Washington, DC 20037, USA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, 3300 Gallows Road, Falls Church, VA 22042, USA; Department of Medicine, Center for Liver Diseases, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA. Electronic address: zobair.younossi@inova.org. ·Clin Liver Dis · Pubmed #28689595.

ABSTRACT: The economic burden of chronic hepatitis C might exceed $10 billion annually in the United States alone. This disease has a worldwide prevalence of up to 3%, making the global burden of the disease comparably tremendous. The cost of the disease includes direct medical expenses for its hepatic and extrahepatic manifestations, and also indirect costs incurred from impaired quality of life and the loss of work productivity. Recent emergence of treatment options that are not only highly effective and safe but also costly has emphasized the need to study the disease from the economic point of view.

25 Review Drugs in Development for Hepatitis B. 2017

Dawood, Altaf / Abdul Basit, Syed / Jayaraj, Mahendran / Gish, Robert G. ·Department of Internal Medicine, Section of Gastroenterology, University of Nevada School of Medicine, Las Vegas, NV, USA. · Department of Internal Medicine, Section of Gastroenterology, University of Nevada School of Medicine, Las Vegas, NV, USA. rgish@robertgish.com. · Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, CA, USA. rgish@robertgish.com. · Hepatitis B Foundation, Doylestown, PA, USA. rgish@robertgish.com. · Asian Pacific Health Foundation, San Diego, CA, USA. rgish@robertgish.com. · National Viral Hepatitis Roundtable, Washington, DC, USA. rgish@robertgish.com. ·Drugs · Pubmed #28660478.

ABSTRACT: With high morbidity and mortality worldwide, there is great interest in effective therapies for chronic hepatitis B (CHB) virus. There are currently several dozen investigational agents being developed for treatment of CHB. They can be broadly divided into two categories: (1) direct-acting antivirals (DAAs) that interfere with a specific step in viral replication; and (2) host-targeting agents that inhibit viral replication by modifying host cell function, with the latter group further divided into the subcategories of immune modulators and agents that target other host functions. Included among the DAAs being developed are RNA interference therapies, covalently closed circular DNA (cccDNA) formation and transcription inhibitors, core/capsid inhibitors, reverse transcriptase inhibitors, hepatitis B surface antigen (HBsAg) release inhibitors, antisense oligonucleotides, and helioxanthin analogues. Included among the host-targeting agents are entry inhibitors, cyclophilin inhibitors, and multiple immunomodulatory agents, including Toll-like receptor agonists, immune checkpoint inhibitors, therapeutic vaccines, engineered T cells, and several cytokine agents, including recombinant human interleukin-7 (CYT107) and SB 9200, a novel therapy that is believed to both have direct antiviral properties and to induce endogenous interferon. In this review we discuss agents that are currently in the clinical stage of development for CHB treatment as well as strategies and agents currently at the evaluation and discovery phase and potential future targets. Effective approaches to CHB may require suppression of viral replication combined with one or more host-targeting agents. Some of the recent research advances have led to the hope that with such a combined approach we may have a functional cure for CHB in the not distant future.

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