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Published on: September 25, 2019
Engineering immune therapy against hepatitis B virus
Fazle Akbar1, Osamu Yoshida, Masanori Abe
1Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
Insights
Chronic hepatitis B virus (HBV) infection affects millions globally, with current treatments offering limited efficacy. This research explores novel HBV-specific immune therapies to improve treatment outcomes for chronic HBV carriers.
Area of Science:
- Immunology
- Hepatology
- Virology
Background:
- Chronic hepatitis B virus (HBV) infection impacts 350-400 million people worldwide, leading to severe liver diseases.
- Current antiviral treatments for chronic HBV are insufficient, failing to eradicate the virus and often causing side effects.
- Host immune responses are critical in HBV infection, influencing disease progression and treatment response.
Purpose of the Study:
- To review the role of immune responses in chronic HBV infection.
- To evaluate the limitations of current antiviral therapies and vaccine therapy for chronic HBV.
- To propose a framework for developing more effective HBV-specific immune therapies.
Main Methods:
- Literature review on HBV immunology and current treatment strategies.
- Analysis of the efficacy and limitations of existing antiviral agents and vaccine therapy.
- Conceptualization of novel HBV-specific immune therapy approaches.
Main Results:
- Existing antiviral drugs offer only partial efficacy and cannot eliminate HBV.
- Current vaccine therapy approaches for chronic HBV carriers show limited long-term success.
- HBV-specific immunity is crucial for controlling viral load and disease progression.
Conclusions:
- There is a need for improved therapeutic strategies beyond current antiviral and vaccine approaches.
- Engineering potent HBV-specific immune therapies holds promise for treating chronic HBV infection.
- Further research into vaccine/host interactions is essential for advancing HBV immunotherapy.
Abstract:
Approximately 350-400 million people worldwide are chronically infected with the hepatitis B virus (HBV). These individuals harbor the virus for their whole life and they transmit the virus to uninfected individuals. In addition, considerable numbers of chronic HBV carriers develop progressive liver diseases like chronic hepatitis B, liver cirrhosis and hepatocellular carcinoma. At present, antiviral agents like type-1 interferons, lamivudine, adefovir and entacavir are used to treat a selected population of chronic HBV carriers. These antiviral treatments are not satisfactory in that they are unable to eradicate HBV, only partially efficient in less than 30% subjects, expensive, can have debilitating side-effects and require constant monitoring. In addition, once treatment is stopped, the virus and clinical conditions return in many patients. Recent advancements in cellular and molecular biology indicate that the host's immune responses to HBV play cardinal roles during acquisition, pathogenesis, progression, and complications of chronic HBV infection. Immune responses are also important in the context of antiviraltherapy and clinical recovery. This explains why the efficacy of antiviral drugs is limited even in some selected patients with chronic HBV infection. Various published work now state that HBV-specific immunity may be beneficial for patients with chronic HBV infection and non-HBV-specific immunity may be related to flare up of liver diseases. Accordingly, a new few field of immunological research and clinical application of prophylactic vaccines (vaccine therapy) has been started in chronic HBV carriers. Vaccine therapy has inspired optimism as a new therapeutic approach, but it is unlikely that the present regimen of vaccine therapy will stand the test of time. Based on present understandings about vaccine/host interactions, we provide herein an outline for engineering more potent regimen of HBV-specific immune therapy against HBV.
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