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慢性乙型肝炎的治愈现状
引用本文:王晶晶,纪 冬,陈国凤. 慢性乙型肝炎的治愈现状[J]. 中国工业医学杂志, 2020, 33(6): 566-570
作者姓名:王晶晶  纪 冬  陈国凤
作者单位:中国人民解放军总医院第五医学中心肝病医学部
基金项目:国家“十三五”科技重大专项(2018ZX10725506-001);中国人民解放军总医院课题(2019MBD-024);首都临床特色研究特色项目(Z181100001718034)
摘    要:
慢性乙型肝炎(chronic hepatitis B, CHB)是一种广泛的全球感染性疾病,是肝细胞癌和肝衰竭的主要原因。目前可以通过接种乙型肝炎疫苗降低CHB的新发感染率,主要的治疗方法是通过聚乙二醇化干扰素α和核苷(酸)类似物抑制病毒,延缓CHB患者的疾病进展,但不能治愈CHB。如何清除稳定的DNA中间体共价闭合环状DNA,以及如何恢复肝脏微环境中疲惫的免疫系统是目前面临的挑战。为此肝病学者们不断探索新的靶标和药物,研究通过针对HBV生活周期不同阶段的药物联合疗法实现持久功能性治愈。本文将对目前CHB的多种治疗策略以及正在研发的新靶标和新药物进行回顾。

关 键 词:慢性乙型肝炎;治疗;治愈;策略

Cure status of chronic hepatitis B
Abstract:
Chronic hepatitis B (CHB) is a widespread global infectious disease and the main cause of hepatocellular carcinoma and liver failure. Currently, the new infection rate of CHB can be reduced by the hepatitis B vaccination. The main treatment is to inhibit the virus by pegylated interferon alpha and nucleo(s)tide analogs, which can delay the disease progression of CHB patients, but a complete HBV cure is currently not possible. On the one hand, the challenge is how to clear the stable DNA intermediate covalently closed circular DNA (cccDNA). On the other hand the challenge is how to restore the tired immune system in the liver microenvironment. Therefore, hepatologists are constantly exploring new targets and drugs to achieve long-lasting functional cure by developing the combined drug therapies targeting different stages in the HBV life cycle. This article reviews the current multiple treatment strategies for CHB and the new targets and new drugs under study.
Keywords:chronic hepatitis B   therapy   cure   strategy
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