Tseng Tai-Chung, Kao Jia-Horng
Department of Internal Medicine, National Taiwan University Hospital Jinshan Branch, New Taipei City, Taiwan.
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
BMC Med. 2017 Mar 15;15(1):53. doi: 10.1186/s12916-017-0820-x.
Chronic hepatitis B virus (HBV) infection is a global public health issue. Although the disease cannot be cured effectively, disease management has been improved over the past decade. The introduction of potent nucleos(t)ide analogues (NAs) to suppress viral replication represented a giant leap in the control of this disease. It has been shown that tenofovir treatment, a potent NA, complements current immunoprophylaxis to diminish mother-to-infant transmission in pregnant women with a high viral load. For patients with chronic HBV infection, quantitative hepatitis B surface antigen is a useful tool to define inactive carriers and to guide antiviral therapy. Quantification of HBV mutants is also useful in predicting long-term outcomes more precisely than ever. The next challenge is how to achieve an HBV cure; although immunotherapy is a promising strategy, the current results from two clinical trials using therapeutic vaccines to induce HBV-specific immune response in patients with chronic HBV infection are disappointing. In the coming years, we are expecting to see a combination of therapeutic agents with various modes of action to complete the mission of HBV elimination.
慢性乙型肝炎病毒（HBV）感染是一个全球性的公共卫生问题。尽管这种疾病无法得到有效治愈，但在过去十年中疾病管理已有所改善。强效核苷（酸）类似物（NAs）的引入以抑制病毒复制，代表了在这种疾病控制方面的巨大飞跃。已表明，替诺福韦治疗作为一种强效NA，可补充当前的免疫预防措施，以减少病毒载量高的孕妇的母婴传播。对于慢性HBV感染患者，定量乙型肝炎表面抗原是定义非活动性携带者和指导抗病毒治疗的有用工具。HBV突变体的定量分析在比以往更精确地预测长期结局方面也很有用。下一个挑战是如何实现HBV治愈；尽管免疫疗法是一种有前景的策略，但目前两项使用治疗性疫苗在慢性HBV感染患者中诱导HBV特异性免疫反应的临床试验结果令人失望。在未来几年，我们期待看到具有各种作用方式的治疗药物组合来完成消除HBV的使命。
