Update on the management and treatment of viral hepatitis

Abstract

This review aims to summarize the current evidence on the treatment of viral hepatitis, focusing on its clinical management. Also, future treatment options and areas of potential research interest are detailed. PubMed and Scopus databases were searched for primary studies published within the last ten years. Keywords included hepatitis A virus, hepatitis B virus (HBV), hepatitis C virus, hepatitis D virus (HDV), hepatitis E virus, and treatment. Outcomes reported in the studies were summarized, tabulated, and synthesized. Significant advances in viral hepatitis treatment were accomplished, such as the advent of curative therapies for hepatitis C and the development and improvement of hepatitis A, hepatitis B, and hepatitis E vaccination. Drugs that cure hepatitis B, going beyond viral suppression, are so far unavailable; however, targeted antiviral drugs against HBV (immunomodulatory therapies and gene silencing technologies) are promising approaches to eradicating the virus. Ultimately, high vaccination coverage and large-scale test-and-treat programmes with high screening rates may eliminate viral hepatitis and mitigate their burden on health systems. The development of curative hepatitis C treatment renewed the enthusiasm for curing hepatitis B, albeit further investigation is required. Novel therapeutic options targeting HDV life cycle are currently under clinical investigation.

Macrophage Polarization and Its Role in Liver Disease

“…Viral hepatitis is a class of infectious diseases caused by hepatitis virus with hepatocyte degeneration, necrosis and apoptosis as the main lesions, including five types: A, B, C, D, and E ( 105 ). It is very likely to form chronic hepatitis after hepatitis virus infection, and then progress to liver fibrosis, ultimately leading to cirrhosis and even HCC ( 105 ). Currently, inhibiting the replication and spread of hepatitis virus by regulating the body’s immune system is the key to the treatment of viral hepatitis ( 106 ).…”

“…Hepatitis B, mainly caused by hepatitis B virus (HBV) infection, is one of the leading causes of chronic hepatitis worldwide ( 105 ). It is generally believed that HBV-related liver damage is associated with the killing of infected-hepatocytes by CD8 + T lymphocytes.…”

Identificación de los polimorfismos rs12979860 y rs8099917 de IL28B en el diagnóstico, control y determinación de tratamiento en pacientes venezolanos infectados con el virus de hepatitis C.

“…El tratamiento de la hepatitis C ha evolucionado rápidamente a lo largo de los últimos años (13). Por mucho tiempo el tratamiento estándar estaba basado en el uso de interferón pegilado junto a ribavirina, a pesar de los efectos secundarios descritos del interferón y una tasa de RVS que apenas sobrepasa el 50 % de los pacientes con el genotipo 1 del VHC (14).…”

Circulating cell-specific extracellular vesicles as biomarkers for the diagnosis and monitoring of chronic liver diseases

“…Targeted weight loss slows progression in mild disease, but is less effective in moderate to severe disease [ 9 ]. Importantly, while there have been considerable breakthroughs in the prevention and treatment of viral hepatitis in recent years [ 10 ], no medicine is currently approved for NAFLD and progress has been slow with costly failures in late phase trials due to an inability to easily monitor treatment response.…”