Combining therapeutic agents to target the immune systems of hepatitis B patients: what do we need to consider?

Abstract

Introduction: Chronic hepatitis B (CHB) remains a major global health challenge, with functional cure achieved in only a small subset of patients. Current oral antiviral agents effectively suppress viral replication but fail to eliminate the hepatitis B virus (HBV). Recent advances in immunomodulatory therapies offer new hope for improving functional cure rates.

Areas covered: This special report discusses the latest therapeutic strategies targeting immune responses in CHB. We list the mechanisms of immune evasion in HBV infection and highlight emerging immunomodulatory agents. Key findings from recent clinical trials and critical considerations are summarized to provide an overview of ongoing efforts and future direction to achieve functional cure.

Expert opinion: While combination therapies hold promise, their real-world feasibility depends on patient selection, combination regimens, costs, and global accessibility. A successful HBV cure strategy must integrate scientific innovation with public health policies to ensure equitable access to effective treatments. Future research should identify key immune mechanisms, optimize combination regimens, and improve global treatment infrastructure.