Overview
Chronic type B viral hepatitis is a persistent infection with the hepatitis B virus (HBV) that can lead to serious liver damage, including cirrhosis and hepatocellular carcinoma. Management aims to suppress viral replication, reduce liver inflammation, and prevent disease progression.Diagnosis
Diagnosis is confirmed by serological markers, including hepatitis B surface antigen (HBsAg) positivity for at least six months, and detection of HBV DNA 1.
Liver biopsy may be used to assess the degree of necroinflammation and fibrosis 1.Management
Antiviral therapy is indicated for patients with chronic HBV infection who have elevated HBV DNA levels, elevated alanine aminotransferase (ALT) levels, and evidence of significant liver disease or fibrosis 1.
First-line antiviral agents include nucleos(t)ide analogs (NUCs) such as entecavir and tenofovir, and pegylated interferon alfa 1.
JNJ-73763989, a siRNA targeting all HBV messenger RNAs, has shown promising pharmacokinetic, safety, and tolerability profiles in healthy participants after a single dose 1.Key Recommendations
Antiviral therapy should be initiated in patients with chronic HBV infection who have elevated HBV DNA, elevated ALT, and evidence of significant liver disease or fibrosis 1. (Evidence: Moderate)
Nucleos(t)ide analogs (e.g., entecavir, tenofovir) and pegylated interferon alfa are considered first-line treatments for chronic hepatitis B 1. (Evidence: Moderate)
JNJ-73763989, a novel siRNA therapeutic, has demonstrated favorable pharmacokinetics and tolerability in healthy individuals, suggesting potential for future clinical application 1. (Evidence: Weak)References
1 Li H, Niu X, Zhang Y, Zhang D, Zhang Y, Wang L et al.. Pharmacokinetics, Safety, and Tolerability of the siRNA JNJ-73763989 in Healthy Chinese Adult Participants. Clinical pharmacology in drug development 2023. link