Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
Department of Clinical Immunology, Medical University of Warsaw, Warsaw, Poland.
Arch Immunol Ther Exp (Warsz). 2019 Apr;67(2):79-88. doi: 10.1007/s00005-018-0532-8. Epub 2018 Nov 15.
The treatment of patients with chronic hepatitis C virus (HCV) infection has changed tremendously over the past 2 years, with an increasing variety of all-oral direct-acting antiviral (DAA) treatment regimens available for different HCV genotypes and distinct clinical settings. These treatments have significantly improved safety in patients with advanced liver disease compared with interferon (IFN)-based regimens. HCV modifies the human immune system to escape immunosurveillance via several mechanisms. One of the basic mechanisms of HCV is the ability to "switch" the immune response by reducing the activity of cells responsible for the elimination of virus-infected cells. IFN-free DAA treatment regimens provide a unique opportunity to assess the effect of HCV elimination on the immune system. Abrupt changes in the immune system can in some cases be responsible for two alarming processes: viral reactivation in patients with chronic hepatitis B and recurrence of hepatocellular carcinoma in patients with previous successful cancer treatment.
在过去的 2 年中，慢性丙型肝炎病毒（HCV）感染患者的治疗发生了巨大变化，越来越多的全口服直接作用抗病毒（DAA）治疗方案可用于不同的 HCV 基因型和不同的临床环境。与基于干扰素（IFN）的方案相比，这些治疗方案显著提高了晚期肝病患者的安全性。HCV 通过多种机制改变人体免疫系统以逃避免疫监视。HCV 的基本机制之一是通过降低负责清除病毒感染细胞的细胞的活性来“切换”免疫反应的能力。无干扰素 DAA 治疗方案为评估 HCV 消除对免疫系统的影响提供了独特的机会。免疫系统的突然变化在某些情况下可能是导致两种令人担忧的过程的原因：慢性乙型肝炎患者的病毒再激活和先前成功癌症治疗患者的肝细胞癌复发。
