Therapeutic vaccination against chronic hepatitis B virus infection.
Chronic liver disease and hepatocellular carcinoma due to chronic hepatitis B virus (HBV) infection pose a major public health problem in highly endemic regions. Effective vaccines against HBV exist but more than 370 million people remain chronically infected with HBV For these patients there is a high risk to develop cirrhosis and hepatocellular carcinoma. Currently available therapies fail to control viral replication in the long term in most patients. Viral persistence has been associated with a defect in the development of HBV specific cellular immunity. Strategies to boost or to broaden the weak virus-specific T-cell response of patients with chronic hepatitis B have been proposed as a means of curing this persistent infection. HBV envelope- and nucleocapsid-based vaccines, new formulations for recombinant vaccines and DNA-based vaccines are currently being assessed in clinical trials. Improvements are clearly required, but vaccination is likely to be the cheapest and potentially most beneficial treatment.
Michel
Marie Louise
ML
Unité de Carcinogénèse Hépatique et Virologie Moléculaire, INSERM U370, Département de Médecine Moléculaire, Institut Pasteur, 75015 Paris, France. maloum@pasteur.fr
Mancini-Bourgine
Maryline
M
D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D017325:Hepatitis B Vaccines / Q000276:immunology / Q000627:therapeutic use*; D019694:Hepatitis B, Chronic / Q000235:genetics / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy; D014614:Vaccines, Synthetic / Q000627:therapeutic use
D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic