HBV: molecular mechanisms and the impact of mutations on the course of infection

Zotkin N.N., Priima E.N., Skvoroda V.V., Esaulenko E.V.

Saint-Petersburg Pasteur Institute, Saint Petersburg, Russia
Saint-Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Hepatitis B remains a global burden to public health. The majority of hepatocellular carcinoma cases are associated with chronic HBV infection. The course of the disease and antiviral therapy efficacy are largely determined by the spectrum of mutations within the viral genome. The complex life cycle of HBV, including the formation of stable covalently closed circular DNA, explains the chronicity of the infection and the difficulty of virus eradication. This review provides a detailed analysis of the molecular mechanisms of HBV replication, as well as clinically significant mutations associated with therapy resistance, and the development of cirrhosis and hepatocellular carcinoma. Analysis of these mechanisms may contribute to the development of new antiviral therapy.