以慢性乙型肝炎的既定和新型疗法实现功能性治愈

StephenW

以慢性乙型肝炎的既定和新型疗法实现功能性治愈
Hannah S J Choi 1、Alexander Tonthat 2、Harry L A Janssen 1、Norah A Terrault 2
隶属关系
隶属关系

    1
    加拿大安大略省多伦多市多伦多总医院多伦多肝病中心。
    2
    美国加利福尼亚州洛杉矶南加州大学凯克医学院。

    PMID：34894108 DOI：10.1002/hep4.1875

抽象的

由于病毒基因组的持续、自我补充性质和宿主免疫反应受损，慢性乙型肝炎病毒 (HBV) 感染仍然难以治愈。目前慢性乙型肝炎 (CHB) 的治疗目标是预防或显着延迟肝脏相关的不良后果和死亡，有两种治疗方法可用：核苷（酸）类似物 (NAs) 和干扰素 (IFN)。 NAs 有效抑制 HBV 复制，而 IFNs 提高血清学反应率，从而降低不良结果的风险。然而，它们在获得血清学反应，尤其是功能性治愈（即血清乙型肝炎表面抗原的丧失）方面的功效非常有限。已经研究了各种策略，例如停止抗病毒治疗或联合治疗，以增强反应，但疗效仅略有提高。重要的是，正在开发新型直接作用抗病毒药物和免疫调节剂，以提高治疗效果并提高功能治愈率。本综述概述了治疗目标和适应症、扩大适应症的可能性，以及在我们继续寻找治愈方法时涉及现有和/或新疗法的不同治疗策略的安全性和有效性。

© 2021 作者。由 Wiley Periodicals LLC 代表美国肝病研究协会出版的 Hepatology Communications。

StephenW

Aiming for Functional Cure With Established and Novel Therapies for Chronic Hepatitis B
Hannah S J Choi  1 , Alexander Tonthat  2 , Harry L A Janssen  1 , Norah A Terrault  2
Affiliations
Affiliations

    1
    Toronto Center for Liver Disease, Toronto General Hospital, Toronto, ON, Canada.
    2
    Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

    PMID: 34894108 DOI: 10.1002/hep4.1875

Abstract

Chronic hepatitis B virus (HBV) infection remains difficult to cure due to the persistent, self-replenishing nature of the viral genome and impaired host immune responses. Current treatment goals for chronic hepatitis B (CHB) are to prevent or significantly delay liver-related adverse outcomes and death, and two types of treatments are available: nucleos(t)ide analogues (NAs) and interferons (IFNs). NAs effectively suppress HBV replication, and IFNs improve serological response rates, thereby decreasing the risk of adverse outcomes. However, their efficacy in attaining serological responses, especially functional cure (i.e., loss of serum hepatitis B surface antigen), is very limited. Various strategies such as stopping antiviral therapy or combining therapies have been investigated to enhance response, but efficacy is only modestly improved. Importantly, the development of novel direct-acting antivirals and immunomodulators is underway to improve treatment efficacy and enhance rates of functional cure. The present review provides an overview of the treatment goals and indications, the possibility of expanding indications, and the safety and efficacy of different treatment strategies involving established and/or novel therapies as we continue our search for a cure.

© 2021 The Authors. Hepatology Communications published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.

StephenW

https://aasldpubs.onlinelibrary. ... t/10.1002/hep4.1875