Immunological mechanisms, novel biomarkers, and therapeutic strategies in hepatitis B management

Chronic hepatitis B virus (HBV) infection remains a major global health challenge, affecting hundreds of millions of individuals worldwide and representing a leading cause of liver cirrhosis, hepatic decompensation, and hepatocellular carcinoma. Despite significant advances in prevention and antiviral therapy, current treatment strategies based on nucleos(t)ide analogues and interferon-based regimens rarely achieve functional cure, defined by sustained hepatitis B surface antigen (HBsAg) loss. Consequently, long-term therapy is often required, raising important questions regarding treatment optimization, monitoring, and discontinuation strategies. In recent years, the growing understanding of HBV immunology and host–virus interactions has stimulated the development of novel immunotherapeutic approaches and new biomarkers capable of more accurately reflecting viral transcriptional activity and host immune status.This Research Topic aims to provide a comprehensive and updated overview of current and emerging strategies in HBV management, with particular emphasis on the immunological mechanisms of viral clearance and the evolving role of novel serological biomarkers in routine clinical practice. While antiviral therapies have successfully suppressed viral replication and improved clinical outcomes, substantial unmet needs remain regarding individualized patient management and functional cure prediction. Quantitative hepatitis B surface antigen (qHBsAg), HBV RNA, and hepatitis B core-related antigen (HBcrAg) have emerged as promising tools to complement conventional virological markers, potentially improving disease staging, monitoring of antiviral efficacy, and decision-making regarding treatment cessation. At the same time, innovative therapeutic approaches—including immune-modulating agents, therapeutic vaccines, and combination strategies aimed at restoring HBV-specific immune responses—are rapidly progressing through clinical development. Through this Research Topic, we seek to integrate recent scientific advances with clinical experience in order to better define the present and future landscape of HBV immunotherapy and diagnosis.This Research Topic welcomes original research articles, reviews, systematic reviews, and perspective manuscripts addressing key aspects of HBV management, immunopathology, and biomarker development. Topics of interest include, but are not limited to: updates in current HBV treatment strategies; emerging therapies and immune-restorative approaches; immunological mechanisms and predictors of functional cure; clinical applications of quantitative HBsAg, HBV RNA, and HBcrAg; biomarker-guided treatment monitoring and discontinuation; real-world implementation of novel serological markers; virological and immunological correlates of treatment response; and challenges associated with integrating innovative biomarkers into everyday clinical practice. Contributions bridging translational research and patient-centered clinical management are particularly encouraged.This Research Topic accepts submissions in the following formats: Brief Research Report, Case Report, Classification, Editorial, FAIR² Data, General Commentary, Hypothesis and Theory, Methods, Mini Review, Opinion, Original Research, Perspective, Review, Systematic Review, and Technology and Code. All published articles will undergo rigorous external peer review and may be subject to publication fees.Please note that manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by robust and relevant validation (clinical cohort or biological validation in vitro or in vivo) are out of scope for this Research Topic. Manuscripts focusing solely on cost-effectiveness studies are also not considered for publication in this journal.Topic Editor Dr. Conrado M Fernandeaz-Rodriguez is Editor in Chief for the Revista Española de Enfermedades Digestivas.Topic Editor Dr. Alejandro Gonzalez Praetorius has participated in conferences sponsored by GILEAD. Topic editors: Alejandro González Praetorius, Conrado M Fernandez-Rodriguez, Adolfo De Salazar Source: https://www.frontiersin.org/research-topics/82863/immunological-mechanisms-novel-biomarkers-and-therapeutic-strategies-in-hepatitis-b-management