慢性乙肝病毒感染的当前治疗

StephenW

Current treatments for chronic hepatitis B virus infections

    Fabien Zoulim1, 2, 3, 4, 5, , Fanny Lebossé1, 2, 3, Massimo Levrero1, 2, 4, 6

    1 Cancer Research Center of Lyon (CRCL), Lyon 69008, France
    2 INSERM, U1052, Lyon 69003, France
    3 University of Lyon, UMR_S1052, UCBL, 69008 Lyon, France
    4 Hospices Civils de Lyon (HCL), 69002 Lyon, France
    5 Institut Universitaire de France (IUF), 75005 Paris, France
    6 DMISM and CLNS IIT Sapienza, Sapienza University Rome, 00161 Rome, Italy

    Available online 15 June 2016

Show less
Choose an option to locate/access this article:


        doi:10.1016/j.coviro.2016.06.004
    Get rights and content

Highlights
•    Chronic hepatitis therapy currently relies on the use of Peg-IFNα, and NUC that inhibit viral polymerase activity.
•    Peg-IFNα induces viral load suppression that is sustainable after treatment cessation in 20% of patients.
•    NUC administration leads to viral load suppression in the majority of patients.
•    Long-term treatment is needed to avoid viral replication because of the persistence of viral cccDNA in the liver.
•    Viral load suppression is associated with a decreased risk of progression of liver disease and hepatocellular carcinoma, but the later is not fully eliminated.
•    A functional cure of infection, that is, HBsAg seroconversion, is achieved in 10% of treated patients. Combination of pegIFN and NUC may provide higher rates of HBs seroconversion in some patient populations.

Over 240 million people worldwide are chronically infected with hepatitis B virus (HBV) and although a prophylactic vaccine and effective antiviral therapies are available, no cure exists. Curative regimens are urgently needed because up to one million deaths per year are caused by HBV-related liver cancer and end-stage liver disease. HBV is an hepatotropic virus which belongs to the Hepadnaviridae family and replicates its DNA genome via a reverse transcriptase mechanism. Effective therapies have been developed for chronic hepatitis B (CHB) infection in the last two decades. They rely on the use of interferon alpha and its pegylated formulation, and on nucleos(t)ide analogs that inhibit viral polymerase activity. Their results are discussed in this review as well as future perspectives.

© 2016 Elsevier B.V. All rights reserved.

StephenW

慢性乙肝病毒感染的当前治疗

    煜Zoulim1，2，3，4，5，，范妮Lebossé1，2，3，马西莫Levrero1，2，4，6

    里昂1癌症研究中心（CRCL），里昂69008，法国
    2 INSERM，U1052，里昂69003，法国
    里昂，UMR_S1052，UCBL，69008法国里昂大学3
    4收容所Civils里昂（HCL），69002，法国里昂
    5区大学研究所法国（IUF），75005巴黎，法国
    6 DMISM和CLNS IIT萨皮恩扎，Sapienza大学罗马，00161罗马，意大利

    2016年可在线6月15日

显示较少
选择一个选项，找到/进入这篇文章：


        DOI：10.1016 / j.coviro.2016.06.004
    获得版权和内容

强调
•慢性肝炎治疗目前依赖于使用钉-IFNα，并且NUC抑制病毒聚合酶活性。
•聚乙二醇化干扰素α诱导病毒载量的抑制是在20％的患者治疗停止后可持续。
•NUC施用导致病毒载量抑制在大多数患者。
•需要长期治疗，以避免因为病毒的cccDNA在肝脏的持久的病毒复制。
•病毒载量抑制与肝病和肝细胞癌的进展的风险降低，但后来没有完全消除。
•感染的功能性治疗，也就是，HBsAg的血清转化，在治疗的患者的10％来实现的。 pegIFN和NUC的组合可能在某些患者群体提供HBs抗体阳转率较高。

全球有超过2.4亿人为慢性感染乙型肝炎病毒（HBV）和虽然预防性疫苗和有效的抗病毒治疗可用，无药可治的存在。目前迫切需要的治疗方案，因为每年高达一万人死于HBV相关的肝癌和终末期肝病引起的。乙型肝炎是一种嗜肝病毒属于嗜肝家族，并通过逆转录酶的机制复制其DNA基因组。有效的疗法已经开发了用于治疗慢性乙型肝炎（CHB）的感染，在过去的二十年。它们依靠使用干扰素α及其PEG化制剂，以及核苷抑制病毒聚合酶活性（）类似物。他们的研究结果在本次审查，以及未来的前景进行讨论。

©保留2016年爱思唯尔B.V.所有权利。