[Therapeutic vaccination in chronic hepatitis B: chance or utopia?]

Current therapy of chronic hepatitis B with interferon-a or lamivudine is directed first of all to reduce viral replication. Unfortunately these relatively expensive therapeutic methods can eliminate the infection in only one third of patients. However the pathogenesis of chronic infection with hepatitis B virus is related mostly to the deficits of specific immune response both cellular and humoral. Therefore research on therapeutic vaccination have been started recently. It was supported by development in the last years vaccines, that applied prophylactically demonstrated extraordinary immunogenicity and efficiency. Short story on research related to use of this low cost method for the fight against one of the most common infectious disease was presented in this paper. Experimental studies and small number of clinical trials with recombinant and lipopeptide vaccines, and the most recent based on viral DNA, demonstrated their safety and simultaneously enriched knowledge on the disease pathogenesis. This therapy did not lead to elimination of the infection in the proportion greater than interferon-a or lamivudine, but enables to faster reduction of its activity. Clinical trials including combined use of current therapeutical standards and vaccine immunotherapy, can be expected in coming years.