Background: Chronic hepatitis B (CHB) remains a major global health challenge, affecting over 292 million people worldwide. The virus, often contracted in early childhood or during pregnancy, can lead to serious liver conditions like cirrhosis, hepatocellular carcinoma, and liver failure. As part of the World Health Organization's strategy to reduce the incidence and mortality of CHB by 2030, improving treatment outcomes through advanced diagnostic and therapeutic strategies is essential. Chronic infection often persists due to the immune system's failure to mount an effective response, leading to lifelong viral persistence.
Aim: This review aims to explore advanced clinical diagnosis techniques for hepatitis B, focusing on the role of pharmacists and laboratories in improving patient management through novel biomarkers and antiviral treatments.
Methods: The article examines current antiviral therapies, including nucleos(t)ide analogues (NUCs) and pegylated interferon alpha (PEG-IFNa), and their mechanisms of action. It also discusses the role of viral biomarkers, such as HBV DNA, HBV RNA, and HBsAg, in monitoring treatment response. The review highlights how laboratory tests can aid in assessing the effectiveness of these therapies, predict prognosis, and help pharmacists in tailoring individualized treatment plans.
Results: Antiviral treatments like NUCs are highly effective in reducing viral replication and improving patient outcomes, though complete eradication of the virus remains challenging due to the persistence of cccDNA. New viral biomarkers, such as HBV pgRNA and HBV DNA levels, offer insight into treatment efficacy and long-term prognosis. These biomarkers provide a non-invasive means to evaluate ongoing viral replication and guide treatment decisions, supporting more personalized care.
Conclusion: Advances in hepatitis B treatment are significantly enhanced by the integration of laboratory-based biomarker assessments. Pharmacists play a crucial role in the management of CHB by using these biomarkers to optimize therapeutic regimens and enhance patient outcomes. Laboratories are essential in the early detection of viral markers and in monitoring therapeutic responses, which are vital for improving treatment strategies and achieving functional cure in CHB patients.