Comprehensive Guide to Hepatitis Advances: Chapter 5 - Antivirals against hepatitis viruses: basic mechanisms

Elsevier, Comprehensive Guide to Hepatitis Advances 2023, Pages 137-152
Jean-Michel Pawlotsky

Treatment of viral infections has made considerable progress over the past 20 years. However, the need for new antiviral drug development is reinforced by the constant emergence or reemergence of viral agents causing outbreaks of various extents and severities. This chapter presents the antiviral strategies available to treat viral infections, those used to treat chronic viral hepatitis, and the mechanisms of action of drugs approved or at the developmental stage. Numerous antiviral options are available to treat patients with chronic viral hepatitis. Treatment of hepatitis C virus infection by combinations of specific direct-acting antivirals has become very simple and leads to a definitive cure of the infection in the vast majority of cases. Treatment of hepatitis B virus (HBV) infection is essentially suppressive and most patients must be treated lifelong. New therapeutic options are at the preclinical or clinical developmental stages to achieve a functional HBV cure after a finite course of therapy. Progress has recently been made in the treatment of hepatitis delta virus infection, but more options are needed for this virus, as well as for chronic hepatitis E virus infection in immunodepressed patients.