Review of antiviral and immunotherapeutic strategies for chronic hepatitis B

This is a narrative review that synthesizes evidence on antiviral and immunotherapeutic strategies for chronic hepatitis B infection. The scope includes entry inhibitors, siRNAs, antisense oligonucleotides, capsid assembly modulators, HBsAg release blockers, therapeutic vaccines, TLR agonists, and immune checkpoint inhibitors.

The authors discuss key outcomes such as functional cure, sustained HBV control, seroconversion, and viral rebound. They note that limited seroconversion and viral rebound are observed with current approaches. Safety concerns persist, though serious adverse events and discontinuations were not reported.

The review identifies gaps, including the need for rational combination therapies to improve outcomes. Limitations acknowledged by the authors include the observational nature of much of the evidence and the lack of reported trial-level data on populations, sample sizes, or follow-up.

Practice relevance underscores the future value of rational combination therapies, but the evidence remains preliminary. Clinicians should interpret findings cautiously, recognizing that functional cure and sustained control are goals rather than established outcomes.