乙肝表面抗原与慢性乙肝的功能性治愈

发布时间：2018-04-29 01:00

  本文选题：慢性乙肝 + 乙肝表面抗原　； 参考：《复旦学报(医学版)》2017年06期

【摘要】：治愈乙肝(功能性治愈乙肝)已成为国内外有关学者研究的重要目标。功能性治愈乙肝的指标为:持久的HBsAg消失(伴有或不伴有血清抗HBs阳性),血清HBV DNA阴性,cccDNA处于非活动转录状态,停止治疗后疾病没有复发。本文在简述HBsAg的已知与未知的基础上,阐述了免疫治疗乙肝的现状,重点介绍了本室研发HBsAg-HBIG治疗性疫苗的实验与临床研究。根据核苷类抗病毒药物可清除HBV DNA,中和性HBsAg抗体的被动免疫作用,已证实HBsAg-HBIG有较强的主动免疫作用,提出了清除HBsAg的"三明治"方案:第一层用抗病毒药物,第二层被动免疫用抗HBs抗体,当血清HBsAg未能测及后,第三层注射HBsAg-HBIG复合物作主动免疫,目标为诱生患者对HBsAg产生持久的免疫,从而使cccDNA处于非活动状态,可能会达到功能性治愈。
[Abstract]:Curing hepatitis B (functional cure hepatitis B) has become an important goal of scholars at home and abroad. The indexes of functional cure hepatitis B were as follows: persistent HBsAg disappeared (with or without serum anti HBs positive, serum HBV DNA negative HBV DNA was inactive transcription state, disease did not recur after stopping treatment. On the basis of brief introduction of the known and unknown HBsAg, the present situation of immunotherapy of hepatitis B was described, and the experimental and clinical research of HBsAg-HBIG therapeutic vaccine in our laboratory was introduced emphatically. According to the passive immune effect of nucleoside antiviral drugs which can clear HBV DNA and neutralize HBsAg antibody, it has been proved that HBsAg-HBIG has strong active immune effect. A "sandwich" scheme for eliminating HBsAg was put forward: the first layer used antiviral drugs. In the second layer of passive immunization, the anti HBs antibody was used. When the serum HBsAg was not detected, the third layer was injected with HBsAg-HBIG complex for active immunization. The goal was to induce the patient to produce lasting immunity to HBsAg, thus making cccDNA inactive. Functional healing may be achieved.
【作者单位】： 复旦大学上海医学院教育部/卫计委医学分子病毒学重点实验室;
【分类号】：R512.62

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