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Liver sampling: a vital window into HBV pathogenesis on the path to functional cure

Gill, US; Pallett, LJ; Kennedy, PTF; Maini, MK; (2018) Liver sampling: a vital window into HBV pathogenesis on the path to functional cure. Gut , 67 (4) 10.1136/gutjnl-2017-314873. Green open access

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Abstract

In order to optimally refine the multiple emerging drug targets for hepatitis B virus (HBV), it is vital to evaluate virological and immunological changes at the site of infection. Traditionally liver biopsy has been the mainstay of HBV disease assessment, but with the emergence of non-invasive markers of liver fibrosis, there has been a move away from tissue sampling. Here we argue that liver biopsy remains an important tool, not only for the clinical assessment of HBV but also for research progress and evaluation of novel agents. The importance of liver sampling has been underscored by recent findings of specialised subsets of tissue-resident immune subsets capable of efficient pathogen surveillance, compartmentalised in the liver and not sampled in the blood. Importantly, the assessment of virological parameters, such as cccDNA quantitation, also requires access to liver tissue. We discuss strategies to maximise information obtained from the site of infection and disease pathology. Fine needle aspirates of the liver may allow longitudinal sampling of the local virus/host landscape. The careful utilisation of liver tissue and aspirates in conjunction with blood will provide critical information in the assessment of new therapeutics for the functional cure of HBV.

Type: Article
Title: Liver sampling: a vital window into HBV pathogenesis on the path to functional cure
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/gutjnl-2017-314873
Publisher version: http://dx.doi.org/10.1136/gutjnl-2017-314873
Language: English
Additional information: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: cccDNA, fine needle aspirate, hepatic fibrosis, hepatitis B, histopathology, liver biopsy, liver immunology, tissue resident cells
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: https://discovery.ucl.ac.uk/id/eprint/10044944
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