The Evolution and Clinical Impact of Hepatitis B Virus Genome Diversity

Overview

Journal Nat Rev Gastroenterol Hepatol

Specialty Gastroenterology

Date 2020 May 30

PMID 32467580

Citations 71

Authors

Peter A Revill

Thomas Tu

Hans J Netter

Lilly K W Yuen

Stephen A Locarnini

Margaret Littlejohn

Affiliations

Soon will be listed here.

Abstract

The global burden of hepatitis B virus (HBV) is enormous, with 257 million persons chronically infected, resulting in more than 880,000 deaths per year worldwide. HBV exists as nine different genotypes, which differ in disease progression, natural history and response to therapy. HBV is an ancient virus, with the latest reports greatly expanding the host range of the Hepadnaviridae (to include fish and reptiles) and casting new light on the origins and evolution of this viral family. Although there is an effective preventive vaccine, there is no cure for chronic hepatitis B, largely owing to the persistence of a viral minichromosome that is not targeted by current therapies. HBV persistence is also facilitated through aberrant host immune responses, possibly due to the diverse intra-host viral populations that can respond to host-mounted and therapeutic selection pressures. This Review summarizes current knowledge on the influence of HBV diversity on disease progression and treatment response and the potential effect on new HBV therapies in the pipeline. The mechanisms by which HBV diversity can occur both within the individual host and at a population level are also discussed.

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