The Impact of Hepatitis B Virus on Liver Disease and Liver Cancer: Molecular Mechanisms and Clinical Implications

An estimated 257 million people worldwide suffer from chronic hepatitis B virus (HBV) infection, making it a major public health concern. Due to its association with chronic liver disease and hepatocellular carcinoma (HCC), the most prevalent type of primary liver cancer, HBV continues to cause significant morbidity and mortality even in the face of an effective preventive vaccine and strong antiviral treatments. Hepatocyte regeneration, chronic inflammation, and immune-mediated liver damage are all components of the complicated, multifactorial process that leads to fibrosis, cirrhosis, and malignant transformation in cases of chronic HBV infection. This article offers a thorough summary of the molecular and cellular processes via which HBV aids in the development of liver illness and cancer.
The pleiotropic functions of the HBx protein, which modify host transcription, cell cycle regulation, and apoptosis; the integration of HBV DNA into the host genome, which causes genomic instability and disrupts essential regulatory genes; and extensive epigenetic modifications, such as DNA methylation, histone modifications, and dysregulation of non-coding RNAs, are important pathogenic features. Furthermore, HBV causes chronic inflammation and oxidative stress, which worsen liver damage and promote neoplastic transformation.
The pathophysiology of HBV has significant clinical ramifications for diagnosis, treatment, and disease surveillance. Covalently closed circular DNA (cccDNA), the viral minichromosome that causes persistent infection, is not eliminated by nucleos(t)ide analogues, despite the fact that they successfully inhibit viral replication. Therefore, the risk of HCC is decreased but not eliminated by current therapies. Promising new therapeutic approaches, such as gene editing, immune-based strategies, and epigenetic modulators targeted at eradicating or silencing HBV reservoirs, have been made possible by advances in molecular biology.
To sum up, a better comprehension of the molecular processes behind HBV-related liver disease is essential for creating novel treatment approaches and honing public health initiatives. To overcome the obstacles of viral persistence, stop the progression of the disease, and eventually find a functional or sterilizing treatment for HBV infection, more research is required.