Evolving Clinical and Virological Perspectives on Hepatitis B And C: A Critical Review

Abstract

The hepatitis B virus (HBV) and hepatitis C virus (HCV) are among the leading causes of chronic liver diseases worldwide. The two viruses, with or without complications such as cirrhosis and liver cancer, are responsible for a large part of the illness and death globally, directly or indirectly. Despite the fact that the scientific world has made huge advances in their diagnosis and treatment, HBV and HCV continue to pose a formidable challenge to health of communities around the world. The current paper seeks to comprehensively and comparatively describe the clinical and virological aspects of HBV and HCV including their epidemiology, pathogenesis, transmission, diagnosis, and therapy. Being a DNA virus, HBV can exist in the form of covalently closed circular DNA (cccDNA) which the cell nucleus can keep as a reservoir, and this persistence makes it possible that restoring a patient completely free of virus may not be achieved, and long-term treatment with antiviral drugs will be necessary in order to maintain a low level of viral load. On the other hand, HCV is an RNA virus and since does not have a stable intracellular reservoir it can be almost completely eradicated in most of cases by the use of direct-acting antivirals (DAAs). Such major differences have resulted the two viruses being targeted for very different prevention and treatment approaches. For instance, there is a highly effective vaccine against HBV while there is not yet a vaccine against HCV.This paper also discusses the major problems in disease control today such as underdiagnosis, restriction of treatment availability, and difficulties in the global elimination of viral hepatitis. By reviewing state-of-the-art knowledge and drawing attention to the main differences between HBV and HCV, the present work demonstrates that there is a great need for specific interventions, better healthcare services, and ongoing research to meet the target of eliminating viral hepatitis as a public health threat.