慢性乙型肝炎病毒和丙型肝炎病毒感染抗病毒治疗的免疫学

StephenW

Source: Hepatology  |  Posted 3 weeks ago
Immunological aspects of antiviral therapy of chronic hepatitis B virus and hepatitis C virus infections; Rehermann B, Bertoletti A; Hepatology (Jul 2014)

  

Hepatitis B virus (HBV) and hepatitis C virus (HCV) cause a large proportion of acute and chronic liver disease worldwide. Over the past decades many immunological studies defined host immune responses that mediate spontaneous clearance of acute HBV and HCV infection. However, host immune responses are also relevant in the context of treatment-induced clearance of chronic HBV and HCV infection. First, the pretreatment level of interferon-stimulated genes as well as genetic determinants of innate immune responses, such as single nucleotide polymorphisms near the IFNL3 gene, are strong predictors of the response to IFN-α-based therapy. Second, IFN-α, which has been a mainstay of HBV and HCV therapy over decades, and ribavirin, which has also been included in interferon-free direct antiviral therapy for HCV, modulate host immune responses. Third, both IFN-α-based and IFN-α-free treatment regimens of HBV and HCV infection alter the short-term and long-term adaptive immune response against these viruses. Finally, treatment studies have not just improved the clinical outcomes, but also provided opportunities to study virus-host interaction. This review summarizes our current knowledge on how a patient's immune response affects the treatment outcome of HBV and HCV infection and how innate and adaptive immune responses themselves are altered by the different treatment regimens. (Hepatology 2014;)

StephenW

资料来源：肝病|发表于3天前
慢性乙型肝炎病毒和丙型肝炎病毒感染抗病毒治疗的免疫学方面的问题; Rehermann B，贝托列提A;肝病（2014年7月）

  

乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）引起的急性和慢性肝脏疾病的很大比例付款。在过去的十年里许多免疫学研究定义的调解急性HBV和HCV感染自发清除宿主的免疫反应。然而，宿主的免疫反应也与此有关的慢性HBV和HCV感染的治疗引起的间隙的情况下。首先，干扰素刺激的基因的预处理级别以及先天免疫反应，如IFNL3基因附近的单核苷酸多态性的遗传决定因素，是响应的强预测因子IFN-α为基础的疗法。其次，IFN-α，这一直是乙肝病毒的支柱和HCV治疗几十年，和利巴韦林，这也被包含在干扰素无直接抗病毒治疗丙型肝炎病毒，调节宿主免疫反应。 HBV的第三，两者的IFN-α为基础的和IFN-α的无治疗方案和丙型肝炎病毒感染改变针对这些病毒的短期和长期的适应性免疫反应。最后，治疗的研究不只是提高了临床疗效，同时也提供了机会来研究病毒与宿主的相互作用。本文总结了如何病人的免疫应答影响乙型肝炎的疗效与丙型肝炎病毒感染，以及如何先天免疫和适应性免疫应答本身是由不同的治疗方案改变了当前的知识。 （2014年肝病）