慢性乙型肝炎抗病毒治疗的现状及进展

Current status and progress of antiviral therapy for chronic hepatitis B

目前慢性乙型病毒性肝炎(chronic hepatitis B,CHB)的治疗包括聚乙二醇化干扰素(pegylated interferon,PEG-IFN)和核苷(酸)类似物[nucleos(t)ide analogs,NAs]。基于IFN的治疗时间是有限的,但只有20%~30%的患者实现血清学反应和持续的治疗后反应。NAs因其长期疗效有限导致治疗期延长,并且长期服用NAs可出现耐药突变体。很多研究结合PEG-IFN的免疫调节特性以及NAs的直接抗病毒活性,试图提高CHB患者的疗效。联合治疗虽然提高了患者的治疗中应答率,但并未改善治疗后反应。因此,目前迫切需要探索新的治疗策略。

Current treatment of chronic hepatitis B(CHB) includes pegylated interferon(PEG-IFN) and nucleos(t)ide analogs(NAs).Interferon-based treatment time is limited,but only 20–30% of patients achieve serological response and sustained post-treatment response.NAs have prolonged treatment due to their limited longterm efficacy,and long-term use of NAs can produce resistant mutants.Many studies have combined the immunomodulatory properties of PEG-IFN and the direct antiviral activity of NAs in an attempt to improve the efficacy of CHB patients.Combination therapy improved the patient’s response rate during treatment but did not improve post-treatment response.Therefore,there is an urgent need to explore new treatment strategies.