Veterinary Research Institute, Hudcova 70, CZ-62100 Brno, Czech Republic.
Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Branisovska 31, CZ-37005 České Budějovice, Czech Republic.
Viruses. 2020 Sep 7;12(9):998. doi: 10.3390/v12090998.
The management of chronic hepatitis B virus (CHB) infection is an area of massive unmet clinical need worldwide. In spite of the development of powerful nucleoside/nucleotide analogue (NUC) drugs, and the widespread use of immune stimulators such as interferon-alpha (IFNα) or PEGylated interferon-alpha (PEG-IFNα), substantial improvements in CHB standards of care are still required. We believe that the future for CHB treatment now rests with advanced therapeutics, vaccination, and precision medicine, if all are to bring under control this most resilient of virus infections. In spite of a plethora of active drug treatments, anti-viral vaccinations and diagnostic techniques, the management of CHB infection remains unresolved. The reason for this is the very complexity of the virus replication cycle itself, giving rise to multiple potential targets for therapeutic intervention some of which remain very intractable indeed. Our review is focused on discussing the potential impact that advanced therapeutics, vaccinations and precision medicine could have on the future management of CHB infection. We demonstrate that advanced therapeutic approaches for the treatment of CHB, in the form of gene and immune therapies, together with modern vaccination strategies, are now emerging rapidly to tackle the limitations of current therapeutic approaches to CHB treatment in clinic. In addition, precision medicine approaches are now gathering pace too, starting with personalized medicine. On the basis of this, we argue that the time has now come to accelerate the design and creation of precision therapeutic approaches (PTAs) for CHB treatment that are based on advanced diagnostic tools and nanomedicine, and which could maximize CHB disease detection, treatment, and monitoring in ways that could genuinely eliminate CHB infection altogether.
慢性乙型肝炎病毒 (CHB) 感染的管理是全球范围内尚未满足的巨大临床需求领域。尽管开发了强大的核苷/核苷酸类似物 (NUC) 药物，并且广泛使用了干扰素-α (IFNα) 或聚乙二醇化干扰素-α (PEG-IFNα) 等免疫刺激剂，但仍需要大幅改善 CHB 的护理标准。我们相信，CHB 治疗的未来在于先进的治疗方法、疫苗接种和精准医学，如果所有这些都能控制这种最具弹性的病毒感染。尽管有大量的活性药物治疗、抗病毒疫苗接种和诊断技术，但 CHB 感染的管理仍未得到解决。造成这种情况的原因是病毒复制周期本身非常复杂，为治疗干预提供了多个潜在目标，其中一些确实非常棘手。我们的综述重点讨论了先进的治疗方法、疫苗接种和精准医学可能对 CHB 感染未来管理产生的影响。我们证明，以基因和免疫疗法为形式的 CHB 治疗的先进治疗方法，以及现代疫苗接种策略，正在迅速涌现，以应对 CHB 治疗中当前治疗方法的局限性。此外，精准医学方法也在加快步伐，从个性化医学开始。基于此，我们认为现在是时候加速设计和创建基于先进诊断工具和纳米医学的 CHB 治疗精准治疗方法 (PTA) 了，这些方法可以最大限度地提高 CHB 疾病的检测、治疗和监测，从而真正消除 CHB 感染。
