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Effect of immune checkpoint inhibitors on patients with hepatitis B virus infection

Hsien-Chen Mon1, Pei-Chang Lee1,2, Chen-Ta Chi1,2,3

  • 1Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Journal of the Chinese Medical Association : JCMA
|December 27, 2024
PubMed

Insights

Achieving a functional cure for Hepatitis B virus (HBV) infection, marked by HBsAg loss, is crucial. Combining immune checkpoint inhibitors with nucleos(t)ide analogs shows promise for HBsAg clearance.

Area of Science:

  • Hepatology
  • Immunology
  • Virology

Background:

  • Hepatitis B virus (HBV) infection is a significant global health issue.
  • T cell exhaustion, driven by the PD-1/PD-L1 axis, contributes to chronic HBV infection.
  • Functional cure (HBsAg loss) is the optimal treatment goal, reducing hepatocellular carcinoma risk.

Purpose of the Study:

  • To explore strategies for achieving functional cure in chronic Hepatitis B virus infection.
  • To evaluate the potential of combining immune checkpoint inhibitors with antiviral therapies.

Main Methods:

  • Review of current treatment modalities for chronic HBV.
  • Analysis of the role of T cell exhaustion in HBV persistence.
  • Assessment of the efficacy of combined immunotherapies and nucleos(t)ide analogs.

Main Results:

  • Interferon and finite antiviral therapies show positive outcomes.
  • Immune checkpoint inhibitors targeting the PD-1/PD-L1 axis can potentially reverse T cell exhaustion.
  • Combining immune checkpoint inhibitors with nucleos(t)ide analogs is a promising strategy for HBsAg loss.

Conclusions:

  • Functional cure, defined by HBsAg seroclearance, is the primary objective for managing chronic HBV.
  • Targeting immune checkpoints alongside antiviral therapy offers a novel therapeutic avenue.
  • This combination approach may be particularly effective in patients with lower HBsAg levels.

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