病毒持续性感染难治愈的因素及对策

Analysis of factors for difficult-to-treat persistent viral infections and strategies for treatment

病毒持续性感染引起的病程多为慢性或反复发作,难以治愈,在部分患者甚至可引发肿瘤或自身免疫性疾病等,是严重危害人类健康及造成社会重大经济负担的常见病及多发病。持续性感染难以治愈的原因涉及病毒基因组与宿主细胞染色体整合,或以附加体的形式长期存在,以及病毒的酶或蛋白抑制机体的免疫应答等特性。此外,机体天然免疫或获得性免疫低下、免疫网络失调及感染微环境改变等,也是病毒建立并维持持续性感染的原因。本文根据持续性感染难以治愈的原因,从病原学与机体免疫应答两方面研讨一些对策,希望以此为切入点,为治疗持续性感染提供新思路与新策略。

The clinical course of persistent viral infections is usually chronic and recurrent ,which may lead to development of tumor or autoimmune diseases , etc . Since persistent infectious diseases occur in a large number of patients ,these infections not only are important issues for public health but also can cause heavy economic burden to the society .The factors involved in the“difficult‐to‐treat”viral persistent infections are related to the genomic characteristics of viruses , their interactions with host chromosomes , either via integration or by presence as episomes , and various inhibitory mechanisms of host immune responses mediated by viral enzymes or proteins .In addition ,defects in host innate and （or） acquired immunity , deregulation of immune responsive network ,and alterations in the local infected microenvironment are also involved to establish and maintain persistent viral infections . This review summarizes the viral and host factors in difficult‐to‐treat persistent viral infections , and presents some ideas and strategies for the treatment of persistent viral infections .