Agrawal Babita, Kumar Rakesh
Babita Agrawal, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada.
World J Gastroenterol. 2016 Jul 7;22(25):5623-6. doi: 10.3748/wjg.v22.i25.5623.
Hepatitis B and C viruses (HBV and HCV), both cause serious chronic infections leading to fatal liver diseases. The prototype therapy for both HBV and HCV was based on IFN-α with or without ribavirin. The advent of direct-acting antivirals (DAA) for both HBV and HCV has remarkably improved the standard of treatment for both infections. While HCV can be eliminated following combination DAA therapy, HBV persists even after treatment, requiring life-long therapy with DAAs. Treatment with DAAs is also associated with high cost, the development of resistance and side effects. There is ample published evidence that both HBV and HCV can be eliminated from infected host cells through non-cytolytic immune mechanisms. We need to identify the mechanisms behind this successful elimination of replicating viruses and develop them into novel immunotherapeutic regimens. Moreover, a synergy of, chemo- and immuno-therapeutic strategies will be necessary to eradicate HBV or HCV from a host.
乙型肝炎病毒和丙型肝炎病毒(HBV和HCV)都会引发严重的慢性感染,导致致命的肝脏疾病。HBV和HCV的传统治疗方法都是基于使用或不使用利巴韦林的α干扰素。针对HBV和HCV的直接抗病毒药物(DAA)的出现显著提高了这两种感染的治疗标准。虽然HCV在接受DAA联合治疗后可以被清除,但HBV即使在治疗后仍会持续存在,需要使用DAA进行终身治疗。使用DAA治疗还伴随着高成本、耐药性的产生和副作用。有大量已发表的证据表明,HBV和HCV都可以通过非细胞溶解免疫机制从受感染的宿主细胞中清除。我们需要确定成功清除复制病毒背后的机制,并将其发展为新的免疫治疗方案。此外,为了从宿主中根除HBV或HCV,化疗和免疫治疗策略的协同作用将是必要的。