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HBV in Key Communities

CE / CME

HBV in Key Communities: Strategies to Overcome Barriers and Elevate Care

Pharmacists: 0.75 contact hour (0.075 CEUs)

Physicians: maximum of 0.75 AMA PRA Category 1 Credit™

Nurse Practitioners/Nurses: 0.75 Nursing contact hour

Released: March 12, 2026

Expiration: March 11, 2027

Su Wang
Su Wang, MD, MPH, FACP
CME/CE Information

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Current Recommended Treatment Options for CHB:  Peginterferon or NAs

Next, we will explore the current state of hepatitis B treatment and  discuss what the future may look like, as we eagerly await more agents with more curative potential.

This slide depicts a timeline of the various hepatitis B treatments that have been approved so far. We have not had any new classes of drugs for HBV treatment since 1998.50

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HBV Therapy: Shifting Goals

An exciting recent development in HBV therapy is how treatment goals are shifting. Our current goals are to achieve sustained viral suppression to decrease progression to cirrhosis and reduce liver-related complications, including HCC. However, the field is currently undergoing a paradigm shift towards functional cure, and hopefully, someday, to complete cure.35,51

Functional cure is defined as sustained loss of HBsAg and undetectable levels of HBV DNA, though covalently closed circular DNA (cccDNA) and integrated DNA are still present. Complete cure is the holy grail, defined as the eradication of all traces of hepatitis B from the liver, including cccDNA and integrated HBV DNA, making it a much more complicated goal.35,51

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Benefits of Functional Cure

The benefits of functional cure are manifold. For patients, surface antigen loss and permanently stopping viral replication can reduce HBV-related complications, even if there is still residual cccDNA.

Achieving functional cure would also avoid the need for long-term daily medication. In addition, it would result in clearance of HDV hepatitis delta, if present, and prevent new HDV infection.

Functional cure could also have a great impact on stigma. Patients often say that as long as they are surface antigen positive, they feel like they have hepatitis B, because surface antigen is the screening tool used in occupational health. So, sustained surface antigen loss would represent a great weight lifted off of them.51-54

In terms of the health system and public health, functional cure would decrease HBV transmission. Furthermore, people who have been functionally cured are much less likely to develop end-stage sequelae of hepatitis B, thereby reducing the health system burden and resulting in economic benefit.51-54

Finally, a paradigm shift towards functional cure would also benefit HCPs (and therefore, patients) by simplifying and streamlining treatment, enabling HCPs to treat more people.51-54

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Achieving Functional Cure

So, where are we in terms of achieving this goal of functional cure?

Right now, our main modes of treatment are nucleos(t)ide analogs that suppress viral replication: entecavir, TDF, and TAF. They must be taken daily. If treatment is stopped, viral replication continues or comes back for the vast majority of people. Currently, the functional cure rate is only 1%.55

Bepirovirsen is an investigational drug in later stages of development, an antisense oligonucleotide that works by blocking viral DNA replication, reducing HBsAg, and activating toll-like receptor 8, which might help the immune system control infection.

So far, results from phase III clinical trials of this drug demonstrate statistically significant and clinically meaningful functional cure rates. The field is eagerly awaiting presentation of further data from these clinical trials in 2026.56-58

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Future HBV Treatment: Mix and Match Combination Therapies

Ultimately, experts are forecasting that consistent achievement of functional cure will likely require some mixing and matching of agents, many of which are still in development.

Currently, the nucleos(t)ide analogs provide suppression of HBV DNA but are unlikely to achieve functional cure on their own. Experts speculate that achievement of functional cure will likely require combining these agents with CAMs, siRNAs, or immunotherapies that target the immune system, such as therapeutic vaccines or TLR agonists. These therapies remain in various stages of development, but they are certainly worth watching.59-61

I am hopeful for more exciting developments in the near future. For now, the field remains something of a puzzle, for which we do not yet have all the pieces.

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