Predictors of treatment efficacy with nucleos(t)ide analogues for chronic hepatitis B

Abstract

Chronic hepatitis B virus (HBV) infection remains a global public health problem. Patients with chronic HBV infection are at increased risk of progression to cirrhosis and development of hepatocellular carcinoma (HCC). The primary goal of therapy is to improve quality of life and survival by preventing disease progression to cirrhosis, HCC, and death. Induction of long-term suppression of HBV replication represents the most important goal of current treatment strategies, and clearance of hepatitis B surface antigen (HBsAg) is its optimal endpoint. Long-term administration of potent nucleos(t)ides analogues (NA) with a high barrier to resistance (entecavir, tenofovir disoproxil fumarate, or tenofovir alafenamide) is the therapy of choice. However, factors associated with response to NA-based antiviral therapy (ART) are not clear and have not been included in treatment recommendations. The purpose of this review is to summarize the results of studies evaluating the influence of factors on the effectiveness of NA-based ART. The study examined the significance of baseline pre-treatment factors (demographic, histological, virological, biochemical) as well as dynamic changes in viral load and HBsAg levels during ART in predicting treatment efficacy.