Therapeutic vaccines and immune-based therapies for the treatment of chronic hepatitis B: perspectives and challenges

J Hepatol. 2011 Jun;54(6):1286-96. doi: 10.1016/j.jhep.2010.12.031. Epub 2011 Jan 14.

Abstract

The treatment of chronic hepatitis B virus (HBV) infection has greatly improved over the last 10 years, but alternative treatments are still needed. Therapeutic vaccination is a promising new strategy for controlling chronic infection. However, this approach has not been as successful as initially anticipated for chronic hepatitis B. General impairment of the immune responses generated during persistent HBV infection, with exhausted T cells not responding correctly to therapeutic vaccination, is probably responsible for the poor clinical responses observed to date. Intensive research efforts are now focusing on increasing the efficacy of therapeutic vaccination without causing liver disease. Here we describe new approaches to use with therapeutic vaccination, in order to overcome the inhibitory mechanisms impairing immune responses. We also describe innovative strategies for generating functional immune responses and inducing sustained control of this persistent infection.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Hepatitis B Vaccines / immunology*
  • Hepatitis B Vaccines / therapeutic use*
  • Hepatitis B virus / immunology
  • Hepatitis B, Chronic / immunology
  • Hepatitis B, Chronic / prevention & control
  • Hepatitis B, Chronic / therapy*
  • Host-Pathogen Interactions / immunology
  • Humans
  • Immunity, Cellular
  • Models, Immunological
  • T-Lymphocytes / immunology
  • Vaccines, DNA / immunology
  • Vaccines, DNA / therapeutic use
  • Viral Load / immunology

Substances

  • Antiviral Agents
  • Hepatitis B Vaccines
  • Vaccines, DNA