Dustin Lynn B
University of Oxford, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, United Kingdom.
Curr Drug Targets. 2017;18(7):826-843. doi: 10.2174/1389450116666150825110532.
Hepatitis C virus (HCV) remains a public health problem of global importance, even in the era of potent directly-acting antiviral drugs. In this chapter, I discuss immune responses to acute and chronic HCV infection. The outcome of HCV infection is influenced by viral strategies that limit or delay the initiation of innate antiviral responses. This delay may enable HCV to establish widespread infection long before the host mounts effective T and B cell responses. HCV's genetic agility, resulting from its high rate of replication and its error prone replication mechanism, enables it to evade immune recognition. Adaptive immune responses fail to keep up with changing viral epitopes. Neutralizing antibody epitopes may be hidden by decoy structures, glycans, and lipoproteins. T cell responses fail due to changing epitope sequences and due to exhaustion, a phenomenon that may have evolved to limit immune-mediated pathology. Despite these difficulties, innate and adaptive immune mechanisms do impact HCV replication. Immune-mediated clearance of infection is possible, occurring in 20-50% of people who contract the disease. New developments raise hopes for effective immunological interventions to prevent or treat HCV infection.
丙型肝炎病毒(HCV)仍然是一个具有全球重要性的公共卫生问题,即使在强效直接作用抗病毒药物的时代也是如此。在本章中,我将讨论对急性和慢性HCV感染的免疫反应。HCV感染的结果受限制或延迟先天性抗病毒反应启动的病毒策略影响。这种延迟可能使HCV在宿主产生有效的T细胞和B细胞反应之前很久就建立广泛感染。HCV的遗传灵活性源于其高复制率和易出错的复制机制,使其能够逃避免疫识别。适应性免疫反应无法跟上不断变化的病毒表位。中和抗体表位可能被诱饵结构、聚糖和脂蛋白隐藏。T细胞反应因表位序列变化和耗竭而失败,耗竭是一种可能已经进化以限制免疫介导病理的现象。尽管存在这些困难,先天性和适应性免疫机制确实会影响HCV复制。感染的免疫介导清除是可能的,在感染该疾病的20%至50%的人中会发生。新的进展为预防或治疗HCV感染的有效免疫干预带来了希望。