Lewandowska Marta, Piekarska Anna
Department of Infectious Diseases and Hepatology, Medical University in Lodz, Lodz, Poland.
Clin Exp Hepatol. 2017 Sep;3(3):119-126. doi: 10.5114/ceh.2017.68831. Epub 2017 Jul 5.
Chronic hepatitis B treatment is available for a long period, allowing disease control and infection suppression, but it is rarely responsible for HBsAg clearance. None of the drugs available aim at cccDNA, the obstacle in HBV infection eradication. Complications related to CHB, such as liver insufficiency, cirrhosis, and hepatocellular carcinoma are reduced in conditions of good viremia suppression, but still exist even after HBsAg seroclearance, what makes a need for urgent forthcoming of new therapeutics. Recent years brought promising and interesting results of experimental approaches, which are directed against different phases of HBV life cycle, target ccc DNA, or boost, and restore host immune response. Unfortunately, encouraging results and on animal models are not always reflected in human. Nevertheless, the multiplicity of novel antivirals allows to expect that at least some of them will enter clinical practice and relieve patients from chronic hepatitis B, fatal and devastating disease.
慢性乙型肝炎的治疗可以长期进行,能够实现疾病控制和感染抑制,但很少能使乙肝表面抗原(HBsAg)清除。现有的药物均未针对共价闭合环状DNA(cccDNA),而它是根除乙肝病毒(HBV)感染的障碍。在病毒血症得到良好抑制的情况下,与慢性乙型肝炎相关的并发症,如肝功能不全、肝硬化和肝细胞癌会减少,但即使在HBsAg血清学清除后仍会存在,这使得迫切需要新的治疗方法。近年来,针对HBV生命周期不同阶段、以cccDNA为靶点或增强并恢复宿主免疫反应的实验方法取得了有前景且有趣的结果。遗憾的是,在动物模型上取得的令人鼓舞的结果并不总是能在人体中得到体现。尽管如此,多种新型抗病毒药物让人期待至少其中一些能够进入临床实践,使患者摆脱慢性乙型肝炎这种致命且具有破坏性的疾病。