丙型肝炎病毒感染治愈后的免疫瘢痕：长期丙型肝炎？

Immunological scars after cure of hepatitis C virus infection: Long-HepC?

机构信息

Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School (MHH), Hannover, Germany; Centre for Individualised Infection Medicine (CiiM), a joint venture between the Helmholtz Centre for Infection Research (HZI) and Hannover Medical School (MHH), Hannover, Germany; TWINCORE, a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany; German Centre for Infection Research (DZIF), partner site Hannover-Braunschweig, Germany; Cluster of Excellence Resolving Infection Susceptibility (RESIST; EXC 2155), Hannover Medical School, Hannover, Germany.

出版信息

Curr Opin Immunol. 2023 Jun;82:102324. doi: 10.1016/j.coi.2023.102324. Epub 2023 Apr 10.

DOI:10.1016/j.coi.2023.102324

PMID:37043890

Abstract

Hepatitis C virus (HCV) infection provides a unique opportunity to study the effects of spontaneous or treatment-induced viral elimination on the human immune system. Twenty to 50% of patients with acute HCV infection spontaneously clear the virus, which is related to the quality of the individual's immune response, while the chronic infection is associated with an altered and impaired immune response. Direct-acting antiviral agents are now available that provide sustained viral elimination in more than 95% of patients with chronic HCV infection. Viral elimination leads to a decrease in disease sequelae such as cirrhosis and hepatocellular carcinoma, and extrahepatic manifestations also improve. However, some patients may still experience long-term complications, and viral elimination does not protect against HCV reinfection. This review addresses the question of whether the altered and impaired immune response caused by HCV normalizes after viral elimination and if this may affect the long-term clinical course after HCV cure.

摘要

丙型肝炎病毒（HCV）感染为研究自发性或治疗诱导的病毒清除对人类免疫系统的影响提供了独特的机会。20%至 50%的急性 HCV 感染患者可自发清除病毒，这与个体免疫反应的质量有关，而慢性感染则与改变和受损的免疫反应有关。目前已有直接作用抗病毒药物，可为超过 95%的慢性 HCV 感染患者提供持续的病毒清除。病毒清除可降低肝硬化和肝细胞癌等疾病的后遗症，并改善肝外表现。然而，一些患者仍可能出现长期并发症，且病毒清除并不能预防 HCV 再感染。本综述探讨了 HCV 引起的改变和受损的免疫反应在病毒清除后是否恢复正常，以及这是否会影响 HCV 治愈后的长期临床病程这一问题。