乙型肝炎病毒的免疫发病机制

StephenW

J Infect Dis. 2017 Nov 16;216(suppl_8):S765-S770. doi: 10.1093/infdis/jix356.
Immunopathogenesis of Hepatitis B Virus.Tseng TC1,2, Huang LR3,4.
Author information
1Department of Internal Medicine, National Taiwan University Hospital-Jinshan Branch, New Taipei City.2Hepatitis Research Center, National Taiwan University Hospital.3Graduate Institute of Clinical Medicine, National Taiwan University, Taipei.4Institute of Molecular and Genomic Medicine, National Health Research Institutes, Miaoli, Taiwan.

AbstractChronic hepatitis B virus (HBV) infection is a global public health issue. There are >250 million people chronically infected with HBV, and these chronic carriers are at high risk of developing end-stage liver diseases and hepatocellular carcinoma. Patients with chronic hepatitis B (CHB) usually acquire the virus perinatally, while most patients infected during adulthood develop acute hepatitis B (AHB), which usually results in viral clearance. HBV infection is noncytopathic, and liver injury is mostly contributed by host immune responses. The virus is stealthy, since the infection rarely induces type I interferon response in the early phase. In AHB, viral infection is detected and restrained by the innate immune response, which is followed by a strong and robust adaptive immune response and accompanied by viral clearance. In patients with CHB, both innate and adaptive immune responses are weak and thus rarely lead to viral clearance. Interferon α and nucleos(t)ide analogues are 2 classes of approved antiviral therapies. The former treatment activates nature killer (NK) cells and NK T cells, which partially enhances the innate immune response, while the later treatment suppresses viral replication by inhibiting reverse transcriptase, which may restore the HBV-specific adaptive immune response. However, single or combined treatment are still far from achieving seroclearance of HBV surface antigen. Although the treatment response is unsatisfactory in current clinical trials using several immunomodulators for boosting antiviral immunity, immunotherapy that is able to induce immune surveillance is still the most promising modality for HBV cure in the future.

© 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: HBV; acute hepatitis B; chronic hepatitis B; immunotherapy

PMID:29156047DOI:10.1093/infdis/jix356

StephenW

J传染病2017年11月16日; 216（suppl_8）：S765-S770。 doi：10.1093 / infdis / jix356。
乙型肝炎病毒的免疫发病机制。
曾经TC1,2，黄LR3,4。
作者信息

1
    新台北市台大医院 - 金山分院内科。
2
    台大医院肝炎研究中心
3
    台湾大学临床医学研究所台北。
4
    台湾苗栗国立卫生研究院分子与基因组医学研究所。

抽象

慢性乙型肝炎病毒（HBV）感染是全球公共卫生问题。长期感染乙肝病毒的人数超过2.5亿，这些慢性携带者发展成为终末期肝病和肝癌的高危人群。慢性乙型肝炎（CHB）患者通常会在围产期感染病毒，而在成年期感染的大多数患者会发生急性乙型肝炎（AHB），这通常会导致病毒清除。 HBV感染是非细胞病变性的，而肝脏损伤主要是由宿主免疫反应所致。病毒是隐身的，因为感染在早期很少诱导I型干扰素应答。在AHB中，病毒感染被先天性免疫反应检测和抑制，其后是强而有力的适应性免疫反应并伴有病毒清除。在CHB患者中，先天性和适应性免疫反应都很弱，因此很少导致病毒清除。干扰素α和核苷（酸）类似物是两类经批准的抗病毒疗法。前者的治疗激活自然杀伤（NK）细胞和NK T细胞，这部分增强了先天免疫反应，而后来的治疗通过抑制逆转录酶抑制病毒复制，这可以恢复HBV特异性适应性免疫应答。然而，单一或联合治疗还远未达到HBV表面抗原的清除。尽管目前使用几种免疫调节剂来提高抗病毒免疫力的临床试验的治疗反应并不令人满意，但能够诱导免疫监视的免疫疗法仍然是未来HBV治疗最有希望的方式。

©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：

HBV;急性乙型肝炎;慢性乙型肝炎;免疫治疗

结论：
    29156047
DOI：
    10.1093 / infdis / jix356