Management of chronic hepatitis B infection: Current treatment guidelines, challenges, and new developments

Table 8 Emerging pipeline drugs for chronic hepatitis B virus infection

Drug name	Mechanism of action	Status
Nucleos(t)ide analogues
Clevudine	Inhibits DNA polymerase	Partial approval
Emtricitabine	Inhibits DNA polymerase	FDA approved for HIV
Nucleos(t)ide analogue prodrugs
Amdoxovir	Inhibits DNA polymerase	II (for HIV)
LB80380	Inhibits DNA polymerase	IIb
Famciclovir	Inhibits DNA polymerase	Abandoned
Pradefovir	Inhibits DNA polymerase	Abandoned
Tenofovir alafenamide (GS 7340)	Inhibits DNA polymerase	II/III
MIV-210	Inhibits DNA polymerase	Abandoned
Non-nucleos(t)ide antivirals
NOV-205 (BAM 205)	Unknown	Approved in Russia
Myrcludex-B	Inhibits viral entry	Ib/IIa
Bay 41-4109	Inhibits viral core formation	I
GLS4	Inhibits HBV viral core assembly	Pre-clinical
Rep 9 AC	Blocks HBsAg release	II
NVR-1221	Capsid inhibitor	Pre-clinical
Immunomodulators
Pegylated interferon lambda	Cytokine modulating innate/adaptive immune response	I
GS-9620	TLR-7 agonist	Pre-clinical
Nitazoxanide	Unknown	II
EHT899	Immune enhancer	II
Therapeutic vaccines
HBV core antigen vaccine	Enhance T cell response	I
HBV-EPV	Immunogenic	Withdrawn
ePA-44	Immunogenic	II
HI-8 HBV	Stimulates IFN-γ producing T cells	II
Others
β-thujaplicinol	Blocks viral ribonuclease H activity	Pre-clinical
ARC520	RNA interference	I
Herbal bushen formula	Down-regulate CD4+ and CD25+ T cells	TCM

HBV: Hepatitis B virus; TCM: Traditional chinese medicine; HBsAg: Hepatitis B surface antigen; HIV: Human immunodeficiency virus; FDA: Food and Drug Administration; IFN: Interferon.