临床和基础乙型肝炎病毒研究未得到满足的需求

StephenW

J Infect Dis. 2017 Nov 16;216(suppl_8):S750-S756. doi: 10.1093/infdis/jix382.
Unmet Needs in Clinical and Basic Hepatitis B Virus Research.Su TH1,2, Kao JH1,2,3,4.
Author information
1Division of Gastroenterology and Hepatology, Department of Internal Medicine.2Hepatitis Research Center.3Department of Medical Research, National Taiwan University Hospital.4Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei.

AbstractChronic hepatitis B (CHB) has become a treatable and controllable disease. The current nucleos(t)ide analogue (NUC) and pegylated interferon therapies effectively help slow disease progression and reduce the risk of cirrhosis, hepatocellular carcinoma (HCC), and CHB-associated mortality. Long-term viral suppression is easily achievable by NUC therapy, with limited adverse reactions. However, several unmet requirements still exist, including safety and risk-stratified HCC surveillance among patients who received long-term NUC therapy. Criteria for determining which patients should receive finite-duration NUC therapy and which should receive combination therapy with both NUC and pegylated interferon remain unsettled. The management of hepatitis B virus (HBV) e antigen-positive viremic patients with normal liver function and the incorporation of new biomarkers to help manage CHB require further exploration. To achieve functional cure (ie, HBV surface antigen seroclearance) and complete cure (ie, eradication of covalently closed circular DNA) of CHB, several challenges in basic research must be addressed, including the development of an efficient cell culture system and animal models for HBV investigation, development of treatment to eradicate covalently closed circular HBV DNA, and development of immunotherapy for CHB. This brief review focuses on unmet needs in both clinical and basic HBV research.

© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

KEYWORDS: Nucleos(t)ide analogues; biomarker; cccDNA; immunotherapy; pegylated interferon

StephenW

J传染病2017年11月16日; 216（suppl_8）：S750-S756。 doi：10.1093 / infdis / jix382。
临床和基础乙型肝炎病毒研究未得到满足的需求。
苏TH1,2，高JH1,2,3,4。
作者信息

1
    胃肠病学与肝病学系，内科。
2
    肝炎研究中心。
3
    台大医院医学研究室。
4
    台湾大学医学院临床医学研究所台北。

抽象

慢性乙型肝炎（CHB）已成为一种可治疗和可控的疾病。目前的核苷（酸）类似物（NUC）和聚乙二醇干扰素治疗有效地帮助减缓疾病进展并减少肝硬化，肝细胞癌（HCC）和CHB相关死亡的风险。 NUC疗法很容易实现长期的病毒抑制，副作用有限。然而，仍然存在一些尚未满足的要求，包括接受长期NUC治疗的患者的安全性和风险分层HCC监测。确定哪些患者应接受有限持续时间的NUC疗法以及哪些患者应接受NUC和聚乙二醇化干扰素的联合疗法的标准仍然不确定。对肝功能正常的乙型肝炎病毒（HBV）e抗原阳性病毒血症患者进行管理并纳入新的生物标志物以帮助治疗慢性乙型肝炎需要进一步的探索。为了实现CHB的功能治愈（即HBV表面抗原清除）和完全治愈（即根除共价闭合的环状DNA），必须解决基础研究中的几个挑战，包括开发高效的细胞培养系统和动物模型HBV调查，根除共价闭合循环HBV DNA的治疗的发展，以及CHB免疫治疗的发展。这个简短的回顾关注于临床和基础HBV研究的未满足的需求。

©作者2017.牛津大学出版社出版的美国传染病协会。版权所有。对于权限，电子邮件：[email protected]。
关键词：

核苷酸（t）ide类似物;生物标志物; cccDNA的;免疫治疗;聚乙二醇干扰素