From the Guidelines
The hepatitis B virus (HBV) does not have a "purpose" in the traditional sense, but rather exists to replicate itself, causing harm to human health by potentially leading to cirrhosis and liver cancer in chronically infected individuals. HBV is a pathogenic organism that evolved to infect human liver cells, consisting of DNA genetic material surrounded by a protein coat, and enters liver cells where it reproduces, potentially causing inflammation and damage to the liver (hepatitis) 1. The virus persists in nature because it has developed effective mechanisms for transmission through blood, bodily fluids, and from mother to child during birth. From an evolutionary perspective, HBV exists to replicate itself, not to serve any function for human health or the ecosystem.
The goals of treatment, as indicated in major international guidelines, include improving survival and quality of life, preventing disease progression (e.g., cirrhosis, decompensation), and reducing the incidence of liver transplantation and HCC 1. Recent studies have shown that antiviral treatment can reduce the risk of HCC by 60% to nearly 80% compared to no treatment 1. The case for offering nucleotide reverse transcriptase inhibitors to a broader spectrum of viremic patients with chronic hepatitis B to prevent cancer is increasingly compelling 1.
Key points to consider:
- HBV is a pathogenic organism that causes harm to human health
- The virus exists to replicate itself, not to serve any function for human health or the ecosystem
- Antiviral treatment can reduce the risk of HCC and improve survival and quality of life
- Recent studies suggest that universal treatment of HBV may be cost-effective in most of the developed world 1
- The current treatment guidelines may not be sufficient to prevent HBV-induced carcinogenesis, and earlier antiviral therapy may be necessary 1.
From the Research
Hepatitis B Virus Infection
The hepatitis B virus (HBV) is a hepatotropic virus that can establish a persistent and chronic infection in humans through immune anergy 2. The purpose of the hepatitis B virus is not explicitly stated in the provided studies, but its effects on the human body are well-documented.
Effects of HBV Infection
- HBV infection can lead to a wide spectrum of liver disease ranging from acute (including fulminant hepatic failure) to chronic hepatitis, cirrhosis, and hepatocellular carcinoma 3.
- Chronic HBV infection can progress to end-stage liver disease, such as liver cirrhosis and hepatocellular carcinoma (HCC) if left untreated 4.
- The course of chronic HBV infection typically comprises different clinical phases, each of which potentially lasts for decades 2.
HBV Replication and Persistence
- HBV replicates through an RNA intermediate and can integrate into the host genome 3.
- The unique features of the HBV replication cycle confer a distinct ability of the virus to persist in infected cells 3.
- Innate immunity plays a crucial role in protecting the host from HBV infection and persistence, but HBV develops strategies to suppress the antiviral immune responses 5.
Treatment and Management
- Current therapy includes antiviral agents that directly act on viral replication and immunomodulators, such as interferon therapy 2.
- Antiviral agents for HBV include reverse transcriptase inhibitors, which are nucleoside or nucleotide analogues that can profoundly suppress HBV replication but require long-term maintenance therapy 2.
- Novel compounds are being actively investigated to achieve the goal of HBV surface antigen seroclearance (functional cure), a serological state that is associated with a higher remission rate and a lower rate of cirrhosis and hepatocellular carcinoma 2.