Clinical Scorecard: Combination Approaches Involving PD-1/PD-L1 Inhibition for Achieving Functional Cure in Chronic Hepatitis B

At a Glance

Key Highlights

• Chronic hepatitis B affects approximately 260 million people globally.
• PD-1/PD-L1 inhibitors can significantly reduce HBsAg levels.
• Combination with pegylated interferon can achieve a functional cure rate of 30%.
• Challenges include optimizing dosing regimens and managing immune-related adverse events.
• Future large-scale randomized controlled trials are needed to assess efficacy and safety.

Guideline-Based Recommendations

Diagnosis

• Functional cure defined as sustained HBsAg loss and durable suppression of HBV replication.

Management

• PD-1/PD-L1 blockade should be used as an adjunct to standard therapies, not as a standalone treatment.

Monitoring & Follow-up

• Monitor for HBV reactivation in HBsAg-positive individuals not receiving antiviral prophylaxis.

Risks

• Moderate risk of HBV reactivation with PD-1/PD-L1 inhibitors.

Patient & Prescribing Data

Patients with chronic hepatitis B who have achieved viral suppression with nucleos(t)ide analogues.

Combination regimens involving PD-1/PD-L1 blockade and pegylated interferon show promise for achieving functional cure.

Clinical Best Practices

• Consider PD-1/PD-L1 inhibitors as part of combination therapy with antiviral agents.
• Identify predictive biomarkers for patient selection in clinical trials.

Related Resources & Content

• Chronic Hepatitis B Overview
• PD-1/PD-L1 Pathway in Hepatitis B