Chronic hepatitis B virus (HBV) infection affects 240 million people worldwide and represents a significant burden on public health. Current antiviral treatment of chronic hepatitis B mainly focuses on inhibiting viral replication. A main deficiency of the current treatment is unable to protect uninfected liver cells or hepatocytes that cleared HBV from next rounds of infection. HBV infection biology shows that natural clearance of HBV cccDNA from infected cells frequently occurs, HBV infection including chronic HBV infection is established and maintained by multiround infection, and the course of HBV infection is largely determined by the number of round of infection. Thus, an effective treatment of HBV infection must block new rounds of infection. A proposed new strategy for treating chronic HBV infection aims to immediately interrupt infection course and to achieve HbsAg seroconversion as early as possible. Under this strategy, a main target of antiviral treatment is extracellular viruses, and an effective therapeutics is specific neutralizing (anti-HBs) antibodies. A difference in tempo and efficiency of treating HBV infection between current antivirals and neutralizing antibody is that the antivirals inhibit viral infection only after cells are virus infected while the neutralizing antibody clears viruses before the infection of cells takes place.
Part of the book: Advances in Treatment of Hepatitis C and B