基于免疫机制的慢性乙型肝炎与功能性治愈研究进展  

Research progress in chronic hepatitis B and functional cure based on immune mechanism

作　　者：毕潇月 程澄 陆慧慧 李明慧 谢尧[1,3] Bi Xiaoyue;Cheng Cheng;Lu Huihui;Li Minghui;Xie Yao(Division 2,Department of Hepatology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Division 1,Department of Hepatology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Division 2,Department of Hepatology,Peking university Ditan Teaching Hospital,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院肝病二科,100015 [2]首都医科大学附属北京地坛医院肝病一科,100015 [3]北京大学地坛医院教学医院肝病二科,100015

出　　处：《中华实验和临床病毒学杂志》2021年第3期317-321,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：首都临床特色应用研究专项(Z151100004015122);国家科技重大专项(2017ZX10201201-001-006,2018ZX10715-005-003-005,2017ZX10201201-002-006);北京市科技计划子课题(D161100002716002);北京市医院管理中心消化内科学科协同发展中心资助课题(XXT28,XXZ0302);北京市医院管理中心临床医学发展专项(XMLX 201706,XMLX202127)。

摘　　要：慢性乙型肝炎的"功能性治愈"意味着患者有良好的临床结局,是慢性乙型肝炎(chronic hepatitis B,CHB)抗病毒治疗追求的理想终点。慢性乙型肝炎患者是否能达到功能性治愈,一方面与病毒的自身性质相关,如表面抗原和e抗原表达水平、病毒的复制和病毒的耐药、突变等,另一方面,也与机体的免疫相关,包括固有免疫和特异性免疫。免疫因素对CHB的功能性治愈起着至关重要的作用,包括干扰素在内的抗病毒药物往往通过调节免疫来发挥抗病毒作用。本文从免疫角度,对其与CHB功能性治愈之间的关系进行综述,以便于为临床上追求"功能性治愈"提供依据,期望为临床实践提供指导。The functional cure of hepatitis B means that patients have good clinical outcomes,which is the ideal endpoint of hepatitis B antiviral treatment.Whether chronic hepatitis B patients can achieve functional cure is related to the nature of the virus itself,such as virus species,virus replication and expression of related proteins,on the other hand,it is also related to the host body's immunity,including innate immunity and specific immunity.Immune factors play a vital role in the functional cure of hepatitis B.Antiviral drugs,including interferon,often play an antiviral role by regulating immunity.This paper reviews the relationship between hepatitis B and functional cure from the perspective of immunity,in order to provide the basis for the clinical pursuit of functional cure,hoping to provide guidance for clinical practice.

关 键 词：乙型肝炎病毒 免疫 乙型肝炎病毒表面抗原 功能性治愈 

分 类 号：R512.62[医药卫生—内科学]