Management and Treatment of Patients with Chronic Hepatitis B: Towards Personalized Medicine

Colombatto, P.; Coco, B.; Bonino, Ferruccio; Brunetto, Maurizia Rossana

doi:10.3390/v14040701

Cited by 8 publications

(5 citation statements)

References 103 publications

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“…Certain patients may exhibit strong immune responses that can be effectively utilized to manage the reactivation of HBV. In contrast, others may necessitate more intensive immune modulation to get the desired effects[ 148 ]. Genetic variables additionally influence treatment variability.…”

Section: Management Strategies For Hbv Reactivationmentioning

confidence: 99%

Overview of the immunological mechanisms in hepatitis B virus reactivation: Implications for disease progression and management strategies

Ma,

Yan,

et al. 2024

World J Gastroenterol

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Hepatitis B virus (HBV) reactivation is a clinically significant challenge in disease management. This review explores the immunological mechanisms underlying HBV reactivation, emphasizing disease progression and management. It delves into host immune responses and reactivation’s delicate balance, spanning innate and adaptive immunity. Viral factors’ disruption of this balance, as are interactions between viral antigens, immune cells, cytokine networks, and immune checkpoint pathways, are examined. Notably, the roles of T cells, natural killer cells, and antigen-presenting cells are discussed, highlighting their influence on disease progression. HBV reactivation’s impact on disease severity, hepatic flares, liver fibrosis progression, and hepatocellular carcinoma is detailed. Management strategies, including anti-viral and immunomodulatory approaches, are critically analyzed. The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation. In conclusion, this comprehensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation. With a dedicated focus on understanding its implications for disease progression and the prospects of efficient management strategies, this article contributes significantly to the knowledge base. The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches, ultimately enhancing disease management and elevating patient outcomes. The dynamic landscape of management strategies is critically scrutinized, spanning anti-viral and immunomodulatory approaches. The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.

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Section: Management Strategies For Hbv Reactivationmentioning

confidence: 99%

Overview of the immunological mechanisms in hepatitis B virus reactivation: Implications for disease progression and management strategies

Ma,

Yan,

et al. 2024

World J Gastroenterol

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“…Current antiviral treatments of chronic hepatitis B (CHB), represented by Peg-interferon-α and Nucleos(t)ide Analogues (NA) achieve a functional cure of HBV infection, defined as HBsAg and HBV DNA clearance, in a limited number of patients [ 16 ]. For this reason, the need to fulfill the tertiary prevention and reach the HBV eradication goal with novel agents is mandatory.…”

Section: Introductionmentioning

confidence: 99%

HBV in Italian Women’s Jail: An Underestimated Problem?

Geremia,

Giovagnorio,

De Vito

et al. 2024

JCM

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Background: There is little information regarding the hepatitis B virus (HBV), vaccination status, and hepatitis B exposure in Italian women’s jails. We aimed to describe the HBV exposure and HBs antibody (anti-HBs) protection levels in female prisoners. Material and methods: A retrospective multicentric study was performed in Italian prisons from 2021 to 2023. Univariate and multivariate analyses were conducted to identify risk factors for HBc antibody (anti-HBc) seropositivity and non-protective anti-HBs titer. Results: We included 156 patients. The median age was 41.0 (IQR 34.0–48.0). Of the studied subjects, 31 (19.9%) had anti-HBc positive titer. Two women were HBsAg positive. In the multivariate analysis, older age [OR 1.06 (CI 1.01–1.11), p = 0.011], North-Eastern European [OR 11.67 (3.29–41.30), p < 0.001] and African origin [OR 6.92 (CI 1.51–31.60), p = 0.013], and drug use [OR 6.55 (CI 1.96–21.9), p = 0.002] were risk factors for HBV exposure. Thirty-seven (32%) women had no history of HBV vaccination. Forty-four (38%) had an anti-HBs non-protective titer. In the multivariate analysis, North-Eastern European origin [OR 4.55 (CI 1.19–17.50), p = 0.027] was associated with unprotective anti-HBs titer. Conclusion: Our results show both the low prevalence of HBV and protection in female prisoners. Age, North-Eastern European and African origin, and drug use have a role in exposure risk to HBV.

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“…Moreover, how to select the suitable patients for a specific drug and treatment strategy has become a research focus, making future research direction toward personalized medicine. [10] To achieve this goal, it is important to demonstrate the mechanism underlying HBV infection.…”

Section: Introductionmentioning

confidence: 99%

“…However, such HBsAg seroconversion rate is low and the immune enhancement may bring the side effects of flu-like symptoms and bone marrow suppression. Moreover, how to select the suitable patients for a specific drug and treatment strategy has become a research focus, making future research direction toward personalized medicine 10 . To achieve this goal, it is important to demonstrate the mechanism underlying HBV infection.…”

Section: Introductionmentioning

confidence: 99%

Single-cell RNA sequencing reveals the immunoregulatory roles of PegIFN-α in patients with chronic hepatitis B

et al. 2023

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Background and Aims: Chronic hepatitis B (CHB) is caused by HBV infection and affects the lives of millions of people worldwide by causing liver inflammation, cirrhosis, and liver cancer. Interferon-alpha (IFN-α) therapy is a conventional immunotherapy that has been widely used in CHB treatment and achieved promising therapeutic outcomes by activating viral sensors and interferon-stimulated genes (ISGs) suppressed by HBV. However, the longitudinal landscape of immune cells of CHB patients and the effect of IFN-α on the immune system are not fully understood. Approach and Results: Here, we applied single-cell RNA sequencing (scRNA-seq) to delineate the transcriptomic landscape of peripheral immune cells in CHB patients before and after PegIFN-α therapy. Notably, we identified three CHB-specific cell subsets, pro-inflammatory (Pro-infla) CD14+ monocytes, Pro-infla CD16+ monocytes and IFNG+ CX3CR1− NK cells, which highly expressed proinflammatory genes and positively correlated with HBsAg. Furthermore, PegIFN-α treatment attenuated percentages of hyperactivated monocytes, increased ratios of long-lived naive/memory T cells and enhanced effector T cell cytotoxicity. Finally, PegIFN-α treatment switched the transcriptional profiles of entire immune cells from TNF-driven to IFN-α-driven pattern and enhanced innate antiviral response, including virus sensing and antigen presentation. Conclusions: Collectively, our study expands the understanding of the pathological characteristics of CHB and the immunoregulatory roles of PegIFN-α, which provides a new powerful reference for the clinical diagnosis and treatment of CHB.

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Management and Treatment of Patients with Chronic Hepatitis B: Towards Personalized Medicine

Cited by 8 publications

References 103 publications

Overview of the immunological mechanisms in hepatitis B virus reactivation: Implications for disease progression and management strategies

Overview of the immunological mechanisms in hepatitis B virus reactivation: Implications for disease progression and management strategies

HBV in Italian Women’s Jail: An Underestimated Problem?

Single-cell RNA sequencing reveals the immunoregulatory roles of PegIFN-α in patients with chronic hepatitis B

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