慢性乙型肝炎抗病毒治疗的最新进展

慢性乙型肝炎(CHB)的最终治疗目标是通过清除乙型肝炎病毒(HBV),使肝功能长期稳定,防止肝硬化、肝细胞癌(HCC)等并发症的发生。迄今共有5种口服核苷酸类似物(NAs)用于CHB,包括3种核苷类似物和2种核苷酸类似物。和干扰素的免疫调节作用不同,NAs的作用机制为在体内磷酸化生成具有抑制病毒DNA聚合酶作用的三磷酸核苷类似物,终止HBV DNA链的延长和合成,从而达到抑制病毒复制的作用。但迄今问世的所有药物均不能清除肝细胞核中的共价闭环DNA,这是HBV病毒持续感染和CHB停药复发的主要原因。

Advances in the Antiviral Treatment for Chronic Hepatitis B

The ultimate goal of treatment for chronic hepatitis B （CHB） is to eliminate hepatitis B virus （HBV） ,so as to stabilize the liver function in long term,and prevent incidence of complications,such as liver cirrhosis（LC） and hepatocellular carcinoma（HCC）. So far a total of five kinds of oral nucleotide analogues（NAs） for CHB,including three kinds of nucleoside analogues and two nueleotide analogues. Unlike the immunoregulatory effects of interferon,the mechanism of NAs is to generate triphosphate analogues with inhihitory effect on virus DNA polymeraso by phosphorylating in the body, so as to terminate the extension and synthesis of HBV DNA chains, arid suppress the viral replication. But all invented drugs cannot eliminate eovalently closed circular DNA（cccDNA） in hepatic cells, which is the main reason for the persistent infection of HBV and recurrence of CHB after drug withdrawal.