Hepatitis B virus resistance to nucleos(t)ide analogue therapy: WHO consultation on questions, challenges, and a roadmap for the field
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Sheila F Lumley Jolynne Mokaya Tongai G Maponga Anna Kramvis Geoffrey Dusheiko William Irving Marion Delphin Khadija Said Louise O Downs Elizabeth Waddilove Motswedi Anderson Collins Iwuji Nokukhanya Msomi Ponsiano Ocama Saeed Hamid Danjuma Adda Rachel Halford Kenneth Kabagambe Kimberley SM Benschop Seth Inzaule Polin Chan Margaret Alia Samson Paul Kiyohiko Izumi Tiara Nisa Jean De Dieu Iragena

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Abstract

In this Review, we summarise outputs from a multidisciplinary consultation convened by WHO between July 11 and 13, 2023, to discuss hepatitis B virus (HBV) drug resistance (HBVDR). Treatment of chronic HBV infection with highly effective nucleos(t)ide analogue agents, tenofovir and entecavir, is a crucial intervention that supports the global goal of elimination of HBV infection as a public health threat. The risk of HBVDR as a threat to treatment outcomes is currently considered low from a public health perspective; however, drug resistance can influence individual outcomes, particularly among those who are treatment-experienced. We highlight the need to develop appropriate prevention, monitoring, and surveillance approaches for HBVDR, to support investment in the global scale-up of HBV diagnosis and treatment. Recommendations for the HBVDR field will ultimately be incorporated into a WHO integrated Global Action Plan for drug-resistant HIV, viral hepatitis, and priority sexually transmitted infections.