Cheng JY, Shan GY, Wan H, Liu YY, Zhang YX, Shi WN, Li HJ. Hepatitis B virus-induced cirrhosis: Mechanisms, global variations, and treatment advances. World J Hepatol 2024; 16(12): 1515-1523 [PMID: 39744198 DOI: 10.4254/wjh.v16.i12.1515]
Corresponding Author of This Article
Hai-Jun Li, MD, PhD, Associate Professor, Institute of Liver Diseases, Institute of Translational Medicine, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130061, Jilin Province, China. hjli2012@jlu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jun-Ya Cheng, Department of Bioengineering, Pharmacy School of Jilin University, Changchun 130061, Jilin Province, China
Guan-Yue Shan, Hui Wan, Yi-Ying Liu, Yu-Xin Zhang, Wen-Na Shi, Institute of Translational Medicine, The First Hospital of Jilin University, Changchun 130061, Jilin Province, China
Hai-Jun Li, Institute of Liver Diseases, Institute of Translational Medicine, The First Hospital of Jilin University, Changchun 130061, Jilin Province, China
Author contributions: Cheng JY, Wan H, Shan GY and Shi WN collected the information; Zhang YX and Liu YY drew and modified the illustrations; Cheng JY wrote the paper; Li HJ revised the paper.
Supported by National Natural Science Foundation of China, No. 81970529; and the Natural Science Foundation of Jilin Province, No. 20230508074RC and No. YDZJ202401218ZYTS.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Jun Li, MD, PhD, Associate Professor, Institute of Liver Diseases, Institute of Translational Medicine, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130061, Jilin Province, China. hjli2012@jlu.edu.cn
Received: July 28, 2024 Revised: October 3, 2024 Accepted: October 24, 2024 Published online: December 27, 2024 Processing time: 124 Days and 1.4 Hours
Abstract
We focus on hepatitis B virus (HBV)-induced cirrhosis, global differences, and the evolution of antiviral treatment strategies. Chronic HBV (CHB) infection affects more than 250 million people globally, leading to cirrhosis and hepatocellular carcinoma. The aim of this article was to synthesize the current understanding of the pathophysiological mechanisms and clinical consequences of HBV-induced cirrhosis, and explore differences in disease progression between geographic regions. Disease progression varies across regions due to differences in HBV subtypes, transmission routes, and immune responses. The challenge of late diagnosis and treatment, particularly in resource-limited areas, highlights the urgency and importance of CHB service expansion. Modern nucleos(t)ide analogues, such as tenofovir and entecavir, have emerged as the main therapeutic regimens to improve clinical outcomes in patients by suppressing viral replication and attenuating liver fibrosis. However, drug resistance challenges highlight the need for ongoing research and personalized treatment strategies. This article highlights the mechanisms and impact of cirrhosis progression in the context of CHB infection, aiming to reduce the incidence of cirrhosis and its serious consequences, thereby improving the long-term health of CHB patients worldwide, especially in Africa.
Core Tip: Understanding the global variation in hepatitis B virus-induced cirrhosis highlights the complex interplay between viral factors, host genetics, and environmental influences. Cirrhosis due to chronic hepatitis B virus (CHB) infection results from a cascade of fibrosis processes driven by persistent viral replication and immune-mediated hepatocyte injury. Over time, evolving antiviral treatment strategies have transformed from interferon-based therapies to nucleos(t)ide analogs, such as tenofovir, which effectively inhibit viral replication and attenuate liver injury. Future research should focus on elucidating new therapeutic targets to improve treatment efficacy and reduce the global burden of cirrhosis associated with CHB infection.
