慢性乙型肝炎免疫功能缺陷与抗病毒治疗现状

The immunodeficiency of chronic hepatitis B and the status of antivirus therapy

乙型肝炎病毒(HBV)感染人体后,特异性细胞免疫是发病的关键环节,细胞免疫应答低下是HBV持续感染的关键因素。目前抗病毒治疗存在持续应答率低、疗程长、病毒变异等一系列问题,主要原因是抗病毒药物只能抑制HBV复制,都不能彻底清除共价闭合环状DNA(cccDNA),也与患者免疫缺陷不能得到充分恢复有一定的关系。因此,抗病毒治疗过程中,如何发挥现有药物各自优点,同时提高患者的特异性细胞免疫功能,加强免疫介导的病毒清除,从而达到彻底清除HBVcccDNA的目的,应成为关注的重点。

Specific cell immunity is the key procedure of pathogenesis after hepatitis B virus（HBV） infection. Cell immunodeficiency is the key factor for HBV persistent infection, At present there exist a series of problems in antiviral therapy such as low response rate, virus variation and so on. The main cause is that antiviral drugs only can inhibit the replication of HBV, but cannot clear covalently closed circular DNA（cccDNA） thoroughly, which is related with the incomplete recovery of immunodeficient patients. Therefore, during antivirus therapy, how to exert respective advantages of available drugs, meanwhile improve specific cell immunity, strenghen the immunity mediated virus removal, to clean up HBVcccDNA thoroughly should become the emphasis to pay attention to.