Anti-hepatitis B virus effects of traditional Chinese medicine: Learning from clinical trials in the past twenty years

Abstract

Hepatitis B virus (HBV) is a serious global public health concern. Although nucleoside drugs and interferons can significantly inhibit HBV replication, issues such as drug resistance and low clinical cure rates remain. Traditional Chinese medicine (TCM) is widely used in the treatment of chronic hepatitis B (CHB) in China, with anti-inflammatory, anti-fibrotic, and liver-protective effects; however, reports on its antiviral effects are still inconsistent. We retrieved multicenter clinical studies and meta-analyses of TCM treatment for CHB over the past two decades. The results revealed that TCM has a certain anti-HBV effect, and when combined with antiviral drugs, it can significantly improve antiviral efficacy. It was demonstrated that TCM most effectively promotes serum HBV e antigen conversion to negative, followed by the ability to reduce HBV DNA levels, facilitating HBV surface antigen loss, and improving the treatment of CHB.

Keywords: Hepatitis B virus; Traditional Chinese medicine; Multicenter clinical studies; Meta-analyses; Chronic hepatitis B

Core Tip: Over the past two decades, multicenter clinical studies and meta-analyses have demonstrated that traditional Chinese medicines (TCM) exhibit certain antiviral properties. When administered in conjunction with nucleoside drugs, TCM can elevate the negative conversion rates or decrease hepatitis B virus e antigen, hepatitis B virus (HBV) DNA, and HBV surface antigen, ultimately enhancing therapeutic outcomes. The underlying antiviral mechanisms may involve reducing the negative immune regulation, augmenting the host immune response, and increasing the levels of HBV-specific cytotoxic T lymphocytes.