Critical Updates on Chronic Hepatitis B Virus Infection in 2021.
Critical Updates on Chronic Hepatitis B Virus Infection in 2021.
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DOI：
10.7759/cureus.19152
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Augustine P
中科院分区：
文献类型：
--
作者：
Philips CA;Ahamed R;Abduljaleel JK;Rajesh S;Augustine P
慢性乙肝病毒感染是一种全球性的医疗负担，表现为慢性肝病、肝硬变、肝功能衰竭和肝癌。目前还没有确定的治愈病毒的方法，尽管广泛的疫苗接种计划减轻了未来人口中肝病的负担，但仍然缺乏从宿主中根除病毒的治疗方案。在这篇综述中，我们详细讨论了宿主中病毒结构和应用生物学的最新进展，审查了当前治疗的最新进展，并探索了正在开发的治疗慢性乙肝的新型和最先进的疗法。此外，我们还特别回顾了与乙肝病毒相关的急性慢性肝功能衰竭(ACLF)的临床最新进展。目前对慢性乙肝病毒感染的治疗方法已经有了重要的更新，包括对处于免疫耐受阶段的患者进行治疗的考虑，以及对治疗终点的一些澄清，以及关于使用核(T)化物抑制剂进行有限治疗的决定。正在进行的关于乙肝病毒生物学的尖端研究帮助我们确定了病毒生命周期中应用新疗法的新靶区。由于基因组学领域的改进，治疗性疫苗、基于载体的治疗和旨在针对宿主整合病毒从而彻底治愈的集中管理的希望可能在不久的将来成为现实。较新的临床预后工具提高了我们对继发于乙肝病毒重新激活的ACLF灾难性综合征的具体治疗选择时机的理解。在这篇综述中，我们详细讨论了有关病毒生物学和新的治疗靶点的相关进展，特别是对乙肝相关ACLF的预后评分和治疗选择的评估。
Chronic hepatitis B virus (HBV) infection is a global healthcare burden in the form of chronic liver disease, cirrhosis, liver failure and liver cancer. There is no definite cure for the virus and even though extensive vaccination programs have reduced the burden of liver disease in the future population, treatment options to eradicate the virus from the host are still lacking. In this review, we discuss in detail current updates on the structure and applied biology of the virus in the host, examine updates to current treatment and explore novel and state-of-the-art therapeutics in the pipeline for management of chronic HBV. Furthermore, we also specifically review clinical updates on HBV-related acute on chronic liver failure (ACLF). Current treatments for chronic HBV infection have seen important updates in the form of considerations for treating patients in the immune tolerant phase and some clarity on end points for treatment and decisions on finite therapy with nucleos(t)ide inhibitors. Ongoing cutting-edge research on HBV biology has helped us identify novel target areas in the life cycle of the virus for application of new therapeutics. Due to improvements in the area of genomics, the hope for therapeutic vaccines, vector-based treatments and focused management aimed at targeting host integration of the virus and thereby a total cure could become a reality in the near future. Newer clinical prognostic tools have improved our understanding of timing of specific treatment options for the catastrophic syndrome of ACLF secondary to reactivation of HBV. In this review, we discuss in detail pertinent updates regarding virus biology and novel therapeutic targets with special focus on the appraisal of prognostic scores and treatment options in HBV-related ACLF.
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影响因子：
4
作者：
Chang, Kyong-Mi;Liu, Mengfei
通讯作者：
Liu, Mengfei
影响因子：
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作者：
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通讯作者：
Yang, Yang
影响因子：
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作者：
Do, Albert;Reau, Nancy S.
通讯作者：
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影响因子：
13.5
作者：
Cornberg, Markus;Lok, Anna Suk-Fong;Zoulim, Fabien
通讯作者：
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