Published online Jun 27, 2024. doi: 10.4254/wjh.v16.i6.900
Revised: May 5, 2024
Accepted: June 3, 2024
Published online: June 27, 2024
Processing time: 87 Days and 22.2 Hours
Achievement of a ‘clinical cure’ in chronic hepatitis B (CHB) implies sustained virological suppression and immunological control over the infection, which is the ideal treatment goal according to domestic and international CHB management guidelines. Clinical practice has shown encouraging results for specific patient cohorts using tailored treatment regimens. These regimens incorporate either nucleos(t)ide analogs, immunomodulatory agents such as pegylated interferon α, or a strategic combination of both, sequentially or concurrently administered. Despite these advancements in the clinical handling of hepatitis B, achieving a clinical cure remains elusive for a considerable subset of patients due to the number of challenges that preclude the realization of optimal treatment outcomes. These include, but are not limited to, the emergence of antiviral resistance, incomplete immune recovery, and the persistence of covalently closed circular DNA. Moreover, the variance in response to interferon therapy and the lack of definitive biomarkers for treatment cessation also contribute to the complexity of achieving a clinical cure. This article briefly overviews the current research progress and existing issues in pursuing a clinical cure for hepatitis B.
Core Tip: Clinical cure has become an ideal goal pursued by chronic hepatitis B (CHB) patients. To enable more patients to achieve this goal, immunotherapy targets, the development of drugs targeting the viral life cycle, gene editing technologies, and the application of other methods have promoted the achievement of a clinical cure for CHB; however, this topic warrants continuous exploration.