乙型肝炎的新发展：治疗目标，药剂和监测工具

StephenW

Expert Rev Clin Pharmacol. 2019 Jan 8. doi: 10.1080/17512433.2019.1567327. [Epub ahead of print]
Novel developments of hepatitis B: treatment goals, agents and monitoring tools.
Mak LY1, Seto WK2,3, Fung J3,4, Yuen MF4.
Author information

1
    a Department of Medicine , Queen Mary Hospital, The University of Hong Kong , Hong Kong.
2
    b Department of Medicine , The University of Hong Kong, Hong Kong; Consultant, Medicine, The University of Hong Kong-Shenzhen Hospital , Shenzhen , China.
3
    c State Key Laboratory for Liver Research , The University of Hong Kong , Hong Kong.
4
    d Department of Medicine , Queen Mary Hospital, The University of Hong Kong , Hong Kong.

Abstract

Chronic hepatitis B (CHB) infection causes considerable morbidity and mortality and hence should be a target for global elimination. In recent years, advances have been made in understanding the disease pathophysiology and the relationship to clinical outcome. Novel treatment targets are actively being sought in the hope of improving the treatment outlook. Areas covered: We discussed the cascade of cure of CHB with respect to the degree of persistence of viral genome and proteins. Several novel antiviral agents either targeting the virus or the host are in different clinical phases of development. Serum hepatitis B core-related antigen and HBV RNA are novel markers, which might have role in prediction of specific clinical outcomes such as development of hepatocellular carcinoma or virological relapse after cessation of antiviral therapy. These markers may also be used to monitor treatment response in the drug trials. Expert commentary: Global elimination of CHB is challenged by extremely low awareness of illness and poor access to care. CHB and its related complications can be reduced by birth dose vaccine, antiviral therapy, and alleviated by complication screening. Treatment options for CHB will expand in the next decade and early functional cure is not an impractical goal.
KEYWORDS:

HBV RNA; RNA interfering gene silencer; antiviral therapy; cirrhosis; core protein allosteric modulator; covalently closed circular DNA; cure; genome editing; global elimination; hepatitis B core-related antigen; hepatitis B virus; hepatocellular carcinoma; immunomodulator; integrated DNA; prevention; programmed cell death protein 1; therapeutic vaccine; vaccination; viral entry inhibitor

PMID:
    30621472
DOI:
    10.1080/17512433.2019.1567327

StephenW

专家Rev Clin Pharmacol。 2019年1月8日doi：10.1080 / 17512433.2019.1567327。 [提前打印]
乙型肝炎的新发展：治疗目标，药剂和监测工具。
Mak LY1，Seto WK2,3，Fung J3,4，Yuen MF4。
作者信息

1
    香港大学玛丽医院医学系。
2
    b香港大学医学系，香港;香港大学医学顾问 - 深圳医院，深圳，中国。
3
    c香港大学肝脏研究国家重点实验室。
4
    d香港大学玛丽医院医学系，香港。

抽象

慢性乙型肝炎（CHB）感染导致相当大的发病率和死亡率，因此应成为全球消除的目标。近年来，在理解疾病病理生理学和与临床结果的关系方面取得了进展。正在积极寻求新的治疗目标，以期改善治疗前景。涵盖的领域：我们讨论了CHB在病毒基因组和蛋白质持久性程度方面的治疗级联。几种靶向病毒或宿主的新型抗病毒剂处于不同的临床开发阶段。血清乙型肝炎核心相关抗原和HBV RNA是新的标志物，可能在预防特定临床结果如肝细胞癌的发展或停止抗病毒治疗后病毒学复发方面发挥作用。这些标记物也可用于监测药物试验中的治疗反应。专家评论：全球消除CHB受到疾病意识极低和获得护理不足的挑战。通过出生剂量疫苗，抗病毒治疗和通过并发症筛查减轻CHB及其相关并发症可以减少。 CHB的治疗方案将在未来十年内扩大，早期功能治愈不是一个不切实际的目标。
关键词：

HBV RNA; RNA干扰基因沉默子;抗病毒治疗;肝硬化;核心蛋白质变构调节剂;共价闭合环状DNA;治愈;基因组编辑;全球淘汰;乙型肝炎核心相关抗原;乙型肝炎病毒;肝细胞癌;免疫调节剂;整合DNA;预防;程序性细胞死亡蛋白1;治疗性疫苗;疫苗接种;病毒进入抑制剂

结论：
    30621472
DOI：
    10.1080 / 17512433.2019.1567327