Toronto Centre for Liver Diseases, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
Toronto Centre for Liver Diseases, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; Department of Gastroenterology and Hepatology, Erasmus Medical Center University Hospital, Rotterdam, Netherlands.
Lancet Infect Dis. 2016 Feb;16(2):e10-21. doi: 10.1016/S1473-3099(15)00436-3. Epub 2016 Jan 13.
The treatment goal for chronic hepatitis B is true eradication of the hepatitis B virus, but this is rarely achieved with first-line treatment regimens because of an inability to disrupt covalently closed circular DNA and an inadequate host immune response. Therefore, new antiviral agents are needed to target various stages of the hepatitis B virus lifecycle and modulation of the immune system. This Review provides a summary of available regimens with their strengths and limitations, and highlights future therapeutic strategies to target the virus and host immune response. These new agents can hopefully lead to a finite duration of treatment, and provide a functional and durable cure for chronic hepatitis B infection.
慢性乙型肝炎的治疗目标是真正清除乙型肝炎病毒,但由于无法破坏共价闭合环状 DNA 和宿主免疫应答不足,一线治疗方案很少能实现这一目标。因此,需要新的抗病毒药物来针对乙型肝炎病毒生命周期的各个阶段和免疫系统的调节。这篇综述总结了现有方案的优缺点,并强调了针对病毒和宿主免疫应答的未来治疗策略。这些新的药物有望实现有限疗程的治疗,并为慢性乙型肝炎感染提供功能性和持久的治愈。