Akbar Sheikh Mohammad Fazle, Al-Mahtab Mamun, Khan Md Sakilur Islam, Raihan Ruksana, Shrestha Ananta
Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan.
Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Ann Transl Med. 2016 Sep;4(18):335. doi: 10.21037/atm.2016.08.48.
Although several antiviral drugs are now available for treatment of patients with chronic hepatitis B (CHB), sustained off-treatment clinical responses and containment of CHB-related complications are not achieved in majority of CHB patients by antiviral therapy. In addition, use of these drugs is endowed with substantial long term risk of viral resistance and drug toxicity. The infinite treatment regimens of antiviral drugs for CHB patients are also costly and usually unbearable by most patients of developing and resource-constrained countries. Taken together, there is a pressing need to develop new and innovative therapeutic approaches for CHB patients. Immune therapy seems to be an alternate therapeutic approach for CHB patients because impaired or distorted or diminished immune responses have been detected in most of these patients. Also, investigators have shown that restoration or induction of proper types of immune responses may have therapeutic implications in CHB. Various immunomodulatory agents have been used to treat patients with CHB around the world and the outcomes of these clinical trials show that the properties of immune modulators and nature and designing of immune therapeutic regimens seem to be highly relevant in the context of treatment of CHB patients. In this review, the general properties and specific features of immune therapy for CHB have been discussed for developing the guidelines of effective regimens of immune therapy for CHB.
尽管目前有几种抗病毒药物可用于治疗慢性乙型肝炎(CHB)患者,但大多数CHB患者通过抗病毒治疗并不能实现持续的停药后临床反应以及控制CHB相关并发症。此外,使用这些药物存在病毒耐药和药物毒性的重大长期风险。CHB患者无限期的抗病毒治疗方案成本也很高,对于大多数发展中国家和资源有限国家的患者来说通常难以承受。综上所述,迫切需要为CHB患者开发新的创新治疗方法。免疫疗法似乎是CHB患者的另一种治疗方法,因为在大多数此类患者中都检测到免疫反应受损、扭曲或减弱。此外,研究人员表明,恢复或诱导适当类型的免疫反应可能对CHB具有治疗意义。世界各地已使用各种免疫调节剂来治疗CHB患者,这些临床试验的结果表明,免疫调节剂的特性以及免疫治疗方案的性质和设计在CHB患者的治疗中似乎高度相关。在这篇综述中,讨论了CHB免疫治疗的一般特性和具体特征,以制定CHB免疫治疗有效方案的指南。