Review
Immunology
Peiyu Zheng, Yongqing Dou, Qinying Wang
Summary: Chronic hepatitis B virus (HBV) infection poses a major threat to global public health, despite increasing vaccination rates. The outcome of HBV infection depends on the interaction between viral replication and host immune response. While innate immunity plays an initial role, long-term immunity is lacking due to HBV's ability to evade detection. Therefore, adaptive immunity involving T cells and B cells is crucial in controlling and clearing HBV infections. However, the persistence of HBV leads to immune tolerance and makes achieving a functional cure challenging.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2023)
Review
Gastroenterology & Hepatology
Sheikh Mohammad Fazle Akbar, Osamu Yoshida, Yoichi Hiasa
Summary: Patients with chronic hepatitis B (CHB) are a long-term reservoir of hepatitis B virus (HBV). If not properly treated, these CHB patients may develop serious complications. Current antiviral drugs for CHB treatment cannot eradicate all forms of HBV and cannot stop the progression of complications for most patients. Therefore, there is an urgent need for the development of new therapies for CHB. Immune dysregulation may be responsible for HBV persistence and liver damage in CHB. Despite 30 years of immune therapies for CHB, an effective regimen of immune therapy is yet to be realized. This review discusses the pros and cons of different immune therapies for CHB patients in the past 30 years to provide insights for the development of an evidence-based, effective, and patient-friendly immune therapy regimen for CHB treatment.
JOURNAL OF GASTROENTEROLOGY
(2022)
Review
Immunology
Shuling Wu, Wei Yi, Yuanjiao Gao, Wen Deng, Xiaoyue Bi, Yanjie Lin, Liu Yang, Yao Lu, Ruyu Liu, Min Chang, Ge Shen, Leiping Hu, Lu Zhang, Minghui Li, Yao Xie
Summary: Functional cure is considered achieved when chronic hepatitis B patients achieve HBsAg seroclearance after treatment. Clearing the virus is challenging due to the difficulty in clearing both cccDNA and integrated dslDNA. High levels of HBsAg in the serum lead to immune system failure, making it unable to produce an effective antiviral response. Only less than 1% of chronic hepatitis B patients are cured annually with antiviral treatment. Coinfection with other viruses such as HIV, HCV, and HDV makes it even more difficult to cure. However, it has been found that patients with coinfection have a higher probability of achieving HBsAg seroclearance, especially those with HBV/HIV coinfection with up to 36% 5-year seroclerance rate. This interesting phenomenon is related to the functional reconstruction of the immune system after antiretroviral therapy (ART).
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Gastroenterology & Hepatology
Miwa Kawanaka, Ken Nishino, Hirofumi Kawamoto, Ken Haruma
Summary: New HBV infections are decreasing due to improved antiviral therapy and vaccination, but still a major cause of liver cancer; early treatment is important to prevent cirrhosis and carcinogenesis caused by HBV; treatment regimen should be determined based on age, sex, family history, and liver fibrosis status, with regular monitoring of patients' conditions.
WORLD JOURNAL OF GASTROENTEROLOGY
(2021)
Review
Immunology
Siyu Li, Na Li, Shanru Yang, Haiyan Deng, Yanguo Li, Yixuan Wang, Jiaqiang Yang, Jiaxin Lv, Lan Dong, Guansen Yu, Xin Hou, Geng Wang
Summary: This review introduces the mechanisms, immune checkpoint expression, and current treatments of chronic hepatitis B (CHB), and discusses the possibilities of using immune checkpoint inhibitors to treat CHB.
INTERNATIONAL IMMUNOPHARMACOLOGY
(2022)
Article
Infectious Diseases
Bingqin Tan, Mei Liu, Liming Wang, Jinhuan Wang, Fang Xiong, Xuli Bao, Yao Gao, Lele Yu, Jun Lu
Summary: The study suggests that the dynamic fluctuations of serum microRNAs could predict the efficacy of antiviral therapy for CHB. There were differences in the expression levels of microRNAs between responder and non-responder groups at baseline and after therapy, with some microRNAs correlated with hepatitis B virus DNA titer and e antigen.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2021)
Article
Immunology
Zhanqing Zhang, Wei Lu, Dan Huang, Xinlan Zhou, Rongrong Ding, Xiufen Li, Yanbing Wang, Weijia Lin, Dong Zeng, Yanling Feng
Summary: This study re-characterized the quantitative levels of HBsAg and HBV DNA in the natural history phases of chronic HBV infection. The results showed that HBsAg and HBV DNA had divergent abilities in predicting significant hepatitis activity in both HBeAg-positive and HBeAg-negative patients.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Gastroenterology & Hepatology
Mi Young Jeon, Beom Kyung Kim, Jae Seung Lee, Hye Won Lee, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Seung Up Kim
Summary: The risk of HCC was found to be very low in the IT-group defined by a low FIB-4 index, while untreated patients with higher FIB-4 indices had a higher risk of HCC. Therefore, appropriate criteria for AVT should be established to reduce the risk of HCC.
CLINICAL AND MOLECULAR HEPATOLOGY
(2021)
Article
Medicine, General & Internal
Na Liu, Nan Yang, Wenqi Ma, Shujuan Yang, Chunhua Hu, Juan Li, Yingren Zhao, Guanghua Xu, Yingli He
Summary: This study suggests that antiviral treatment should be considered for CHB patients with high viral load regardless of the disease activity phase to minimize further hepatocyte damage.
FRONTIERS IN MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Peilin Xie, Bilian Yao, Dao Huang, Yongyan Chen, Qiming Gong, Xinxin Zhang
Summary: Expression of sCD163 and CD163 on monocytes is associated with inflammation and HBsAg loss in chronic hepatitis B, and can be used as markers to predict HBV-specific immune activation.
JOURNAL OF CLINICAL AND TRANSLATIONAL HEPATOLOGY
(2022)
Article
Immunology
Si Xie, Liu Yang, Xiaoyue Bi, Wen Deng, Tingting Jiang, Yanjie Lin, Shiyu Wang, Lu Zhang, Ruyu Liu, Min Chang, Shuling Wu, Yuanjiao Gao, Hongxiao Hao, Ge Shen, Mengjiao Xu, Xiaoxue Chen, Leiping Hu, Yao Lu, Rui Song, Yao Xie, Minghui Li
Summary: The activation of CD8+ T lymphocytes is associated with the occurrence of acute and chronic hepatitis B. CD8+ T lymphocytes play an important role in the development of hepatitis B, and their activation status is correlated with the progression of the disease.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Gastroenterology & Hepatology
Yanqin Du, Olympia E. Anastasiou, Benedikt Strunz, Janina Scheuten, Birgit Bremer, Anke Kraft, Karolina Kleinsimglinhaus, Daniel Todt, Ruth Broering, Matthias Hardtke-Wolenski, Jun Wu, Dongliang Yang, Ulf Dittmer, Mengji Lu, Markus Cornberg, Niklas K. Bjorkstrom, Tanvi Khera, Heiner Wedemeyer
Summary: The study assessed the effects of HBsAg quantities on NK cell functionality in CHB patients, finding a reshaping of the NK cell pool towards more CD56(bright) NK cells during infection. Patients with low HBsAg levels displayed an activated NK cell phenotype with defective functional responses.
LIVER INTERNATIONAL
(2021)
Article
Gastroenterology & Hepatology
Hye-Lin Kim, Gi-Ae Kim, Jae-A Park, Hye-Rim Kang, Eui-Kyung Lee, Young-Suk Lim
Summary: This study found that starting antiviral therapy in the immune-tolerant phase is more cost-effective compared with delaying treatment until the active hepatitis phase in CHB patients, especially with increasing hepatocellular carcinoma risk, decreasing drug costs, and consideration of productivity loss.
Review
Gastroenterology & Hepatology
Hua-Jun Zhao, Yi-Fei Hu, Qiu-Ju Han, Jian Zhang
Summary: This review provides a detailed explanation of the immunological and biological characteristics of chronic hepatitis B virus infection, as well as the escape mechanisms of the virus. It also discusses novel immune-based therapies for treating hepatitis B virus.
WORLD JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Nutrition & Dietetics
Sheng-Jie Shiue, Chao-Ling Cheng, Han-Shiang Shiue, Chun-Nan Chen, Sheng-Wei Cheng, Li-Wei Wu, Ganbolor Jargalsaikhan, Tze-Sian Chan, Hsin-Yi Lin, Ming-Shun Wu
Summary: This study found that oral Arthrospira as an add-on therapy can reduce HBsAg levels in CHB patients and improve immune function by promoting the activation of B cells, T cells, and NK cells.