HCV感染者抗病毒治疗前后免疫状态的变化

Change in immune status after antiviral therapy in patients with hepatitis C virus infection

HCV感染是全球性的公共问题。目前我国主要的抗HCV治疗方案是聚乙二醇干扰素联合利巴韦林,但是该方案的持续病毒学应答率并不理想;直接抗病毒药物(DAA)的出现,在治疗丙型肝炎患者中取得了显著的疗效。简述了抗HCV治疗前后机体免疫状态的变化情况,从固有免疫、适应性免疫以及细胞因子和趋化因子三个方面进行了介绍。分析表明,HCV患者机体的免疫调控十分复杂,不同的研究结果不尽相同。但是总体来看,经过抗病毒治疗后,NK细胞表面受体表达以及其功能有恢复的趋势,甚至可以恢复至正常化;IFN的治疗并不能恢复病毒特异性CD8+T淋巴细胞的功能,而DAA治疗前后细胞毒性T淋巴细胞的变化规律尚未阐明;DAA对细胞因子以及趋化因子的长期的影响仍需要进一步研究。

Hepatitis C virus（HCV） infection is a global public health issue.At present,pegylated interferon（IFN） combined with ribavirin is the major therapeutic regimen for anti-HCV treatment in China,but this regimen cannot achieve ideal sustained virologic response.Direct-acting antivirals（DAA） have achieved marked clinical effects in the treatment of patients with hepatitis C.This article briefly describes the change in immune status after anti-HCV treatment from the three aspects of innate immunity,adaptive immunity,and cytokines/chemokines.The analysis shows that HCV patients have complex immunoregulation,and the results vary from one study to another.In general,the expression of NK cell surface receptor and its function tend to recover and may even recover to a normal state.IFN treatment cannot restore the function of virus-specific CD8＋T lymphocytes,while the change in cytotoxic T lymphocytes after DAA treatment has not been clarified.Further studies are needed to elucidate the long-term effect of DAA on cytokines and chemokines.