Immune therapies against chronic hepatitis B

Abstract

Patients with chronic hepatitis B (CHB) represent a living and permanent reservoir of hepatitis B virus (HBV). Millions of these CHB patients will eventually develop complications such as liver cirrhosis, hepatic failure, and hepatocellular carcinoma if they are not treated properly. Accordingly, several antiviral drugs have been developed for the treatment of CHB, but these drugs can neither eradicate all forms of HBV nor contain the progression of complications in most patients with CHB. Thus, the development of new and novel therapeutics for CHB remains a pressing need. The molecular and cellular mechanisms underlying the pathogenesis of CHB indicate that immune dysregulations may be responsible for HBV persistence and progressive liver damage in CHB. This provided the scientific and ethical basis for the immune therapy of CHB patients. Around 30 years have passed since the initiation of immune therapies for CHB in the early 1990s, and hundreds of clinical trials have been accomplished to substantiate this immune treatment. Despite these approaches, an acceptable regimen of immune therapy is yet to be realized. However, most immune therapeutic agents are safe for human usage, and many of these protocols have inspired considerable optimism. In this review, the pros and cons of different immune therapies, observed in patients with CHB during the last 30 years, will be discussed to derive insights into the development of an evidence-based, effective, and patient-friendly regimen of immune therapy for the treatment of CHB.

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“…The efficacy of the peptide CIGB-325 to reduce pulmonary lesions in adults hospitalized with COVID-19 has also been demonstrated in a randomized, controlled clinical trial [8]. A nasal vaccine for the treatment of chronic Hepatitis B showed safety and efficacy three years after the end of treatment [9].…”

Safety profile, antiviral capacity, and liver protection of a nasal therapeutic vaccine in patients with chronic hepatitis B: Five-year-follow-up outcomes after the end of treatment

“…A short account of the procedures is provided for ready reference. The general parameters of inflammation and serum levels of bilirubin, albumin, and creatinine were determined using the same methods used for the total duration of follow-up (15)(16)(17).…”

“…This has opened a new field of development for immune therapeutic agents for treating patients with CHB. The development of immune therapy against CHB began in the mid-1990s ( 16 , 17 ). However, the following factors seem to be responsible for the lack of a recognized and effective therapeutic agent for CHB ( 17 ).…”

“…The development of immune therapy against CHB began in the mid-1990s ( 16 , 17 ). However, the following factors seem to be responsible for the lack of a recognized and effective therapeutic agent for CHB ( 17 ). In most instances, preclinical animal studies have not retrieved proper evidence to translate immunotherapy in patients with CHB.…”

“…However, these studies were not designed to provide long-term follow-up data to assess the therapeutic implications of these agents. Finally, there is little or no information regarding the mechanism of action of immune therapeutics ( 17 ).…”