A Review of Hepatitis B Virus and Hepatitis C Virus Immunopathogenesis

• 作 者: Corey Saraceni John Birk
• 机 构: University of Connecticut School of Medicine,Department of Medicine,Division of Gastroenterology and
• 出 处: 临床与转化肝病杂志（英文版）
• 发表日期: 2004年期
• 关键词: Hepatitis B immunopathogenesis Hepatitis C immunopathogenesis

Despite the advances in therapy, hepatitis B virus (HBV) and hepatitis C virus (HCV) still represent a significant global health burden, both as major causes of cirrhosis, hepatocel-lular carcinoma, and death worldwide. HBV is capable of incor-porating its covalently closed circular DNA into the host cell\'s hepatocyte genome, making it rather difficult to eradicate its chronic stage. Successful viral clearance depends on the complex interactions between the virus and host\'s innate and adaptive immune response. One encouraging fact on hepatitis B is the development and effective distribution of the HBV vaccine. This has significantly reduced the spread of this virus. HCV is a RNA virus with high mutagenic capacity, thus ena-bling it to evade the immune system and have a high rate of chronic progression. High levels of HCV heterogeneity and its mutagenic capacity have made it difficult to create an effec-tive vaccine. The recent advent of direct acting antivirals has ushered in a new era in hepatitis C therapy. Sustained virolog-ic response is achieved with DAAs in 85–99％ of cases. How-ever, this still leads to a large population of treatment failures, so further advances in therapy are still needed. This article reviews the immunopathogenesis of HBV and HCV, their prop-erties contributing to host immune system avoidance, chronic disease progression, vaccine efficacy and limitations, as well as treatment options and common pitfalls of said therapy.