Evaluation of the Potency of Repurposed Antiretrovirals in HBV Therapy: A Narrative Investigation of the Traditional Medicine Alternatives

Hepatitis B is one of the killer communicable diseases, with a global estimation of 1.1 million deaths resulting from liver diseases annually. The search for HBV therapeutics has resulted in repurposing the existing antiretrovirals (ARVs) for HBV treatment, considering their shared common replication mechanisms. This review is aimed at evaluating the potencies of some of the repurposed ARVs used for HBV treatment, analyzing the common mechanisms of viral replications in HBV and HIV, and investigating the potentials of traditional medicines as an alternative treatment for HBV patients. The topical keywords drug repurposing, drug repositioning, antiretrovirals, hepatitis B treatment, HBV, natural products, traditional medicines, title, and abstract were searched in PubMed, Web of Science, and Google Scholar. The advanced search included the five years, 2019-2024. The search result was filtered from 377 to 110 relevant articles. The evaluation reveals that CD4+ T cells are targeted by HIV, while HBV targets the liver with its associated diseases (cirrhosis and hepatocellular carcinoma (HCC)). Furthermore, treatments with the available repurposed ARVs only prevent or slow down the progression to cirrhosis, reduce the HCC incidence, and can improve the quality of life and increase life expectancy; however, they are not curative for HBV. Traditional medicines/natural product extracts or their phytochemicals exert anti-HBV effects through different mechanisms. Traditional medicines exert improved therapeutic effects when combined properly. The investigation further reveals that consideration of an in silico approach in HBV therapeutics might not only streamline drug development but also contribute to a deeper understanding of viral pathogenesis. Therefore, we recommend the integration of computational drug design methods with traditional medicine and natural product screening for discovering new bioactive HBV drug candidates.