Toronto Centre for Liver Disease and Toronto General Hospital Research Institute, University Health Network, Toronto, Canada; Department of Immunology, University of Toronto, Toronto, Canada.
Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany; German Center for Infection Research (DZIF), Munich partner site, Munich, Germany.
Gastroenterology. 2019 Jan;156(2):325-337. doi: 10.1053/j.gastro.2018.10.032. Epub 2018 Oct 24.
Fewer than 1% of chronic hepatitis B virus infections per year are cured with antiviral treatment. This creates a need for long-term treatment, which poses challenges for patients and health systems. Because cure is accompanied by recovery of antiviral immunity, a combination of direct-acting antiviral agents and immunotherapy are likely to be required. Extensive efforts have been made to identify determinants of the failed immune response to hepatitis B virus in patients with chronic infection. We review mechanisms of immune dysfunction in patients with chronic hepatitis B virus infection, immunotherapy strategies in development, and the challenges associated with successful implementation of immunotherapy.
每年仅有不到 1%的慢性乙型肝炎病毒感染者能够通过抗病毒治疗实现治愈。这就需要长期治疗,给患者和医疗系统带来了挑战。由于治愈伴随着抗病毒免疫的恢复,因此可能需要联合使用直接作用抗病毒药物和免疫疗法。人们已经做出了广泛的努力来确定慢性感染患者对乙型肝炎病毒免疫反应失败的决定因素。我们综述了慢性乙型肝炎病毒感染者免疫功能障碍的机制、正在开发中的免疫疗法策略,以及成功实施免疫疗法所面临的挑战。