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新型乙型肝炎治疗药物:治愈之路。

New Therapeutics for Hepatitis B: The Road to Cure.

机构信息

Department of Medicine, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina 27701, USA; email:

Duke Clinical Research Institute, Durham, North Carolina 27701, USA.

出版信息

Annu Rev Med. 2021 Jan 27;72:93-105. doi: 10.1146/annurev-med-080119-103356. Epub 2020 Oct 21.

Abstract

Chronic hepatitis B virus (HBV) infection impacts an estimated 257-291 million people globally. The current approach to treatment for chronic HBV infection is complex, reflecting a risk:benefit approach driven by the lack of an effective curative regimen. This complexity and the lack of a durable treatment response, necessitating indefinite treatment in the majority of cases, have resulted in low uptake of testing and treatment, particularly in regions where comprehensive primary care is lacking and access to affordable testing and treatment is limited. Multiple targeted therapies are now in early human study with the primary goal to achieve persistent HBV DNA and hepatitis B surface antigen suppression after a finite course of treatment, which is referred to as functional cure. This article summarizes the current therapies for HBV infection and discusses the limitations of these therapies, novel approaches to HBV cure, and therapeutic endpoints of clinical trials aimed to cure hepatitis B.

摘要

全球估计有 2.57 亿至 2.91 亿人患有慢性乙型肝炎病毒 (HBV) 感染。目前慢性 HBV 感染的治疗方法较为复杂,这反映了一种风险:效益方法,其驱动力是缺乏有效的根治方案。这种复杂性以及缺乏持久的治疗反应,使得大多数情况下需要无限期治疗,导致检测和治疗的接受率较低,特别是在缺乏综合初级保健和负担得起的检测和治疗的地区。目前有多种靶向治疗正在进行早期人体研究,其主要目标是在有限疗程的治疗后实现持续的 HBV DNA 和乙型肝炎表面抗原抑制,这被称为功能性治愈。本文总结了目前用于治疗 HBV 感染的疗法,并讨论了这些疗法的局限性、HBV 治愈的新方法以及旨在治愈乙型肝炎的临床试验的治疗终点。

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