本文選題：慢性乙肝 + 乙肝表面抗原　； 參考：《復旦學報(醫(yī)學版)》2017年06期

【摘要】：治愈乙肝(功能性治愈乙肝)已成為國內外有關學者研究的重要目標。功能性治愈乙肝的指標為:持久的HBsAg消失(伴有或不伴有血清抗HBs陽性),血清HBV DNA陰性,cccDNA處于非活動轉錄狀態(tài),停止治療后疾病沒有復發(fā)。本文在簡述HBsAg的已知與未知的基礎上,闡述了免疫治療乙肝的現(xiàn)狀,重點介紹了本室研發(fā)HBsAg-HBIG治療性疫苗的實驗與臨床研究。根據(jù)核苷類抗病毒藥物可清除HBV DNA,中和性HBsAg抗體的被動免疫作用,已證實HBsAg-HBIG有較強的主動免疫作用,提出了清除HBsAg的"三明治"方案:第一層用抗病毒藥物,第二層被動免疫用抗HBs抗體,當血清HBsAg未能測及后,第三層注射HBsAg-HBIG復合物作主動免疫,目標為誘生患者對HBsAg產生持久的免疫,從而使cccDNA處于非活動狀態(tài),可能會達到功能性治愈。
[Abstract]:Curing hepatitis B (functional cure hepatitis B) has become an important goal of scholars at home and abroad. The indexes of functional cure hepatitis B were as follows: persistent HBsAg disappeared (with or without serum anti HBs positive, serum HBV DNA negative HBV DNA was inactive transcription state, disease did not recur after stopping treatment. On the basis of brief introduction of the known and unknown HBsAg, the present situation of immunotherapy of hepatitis B was described, and the experimental and clinical research of HBsAg-HBIG therapeutic vaccine in our laboratory was introduced emphatically. According to the passive immune effect of nucleoside antiviral drugs which can clear HBV DNA and neutralize HBsAg antibody, it has been proved that HBsAg-HBIG has strong active immune effect. A "sandwich" scheme for eliminating HBsAg was put forward: the first layer used antiviral drugs. In the second layer of passive immunization, the anti HBs antibody was used. When the serum HBsAg was not detected, the third layer was injected with HBsAg-HBIG complex for active immunization. The goal was to induce the patient to produce lasting immunity to HBsAg, thus making cccDNA inactive. Functional healing may be achieved.
【作者單位】： 復旦大學上海醫(yī)學院教育部/衛(wèi)計委醫(yī)學分子病毒學重點實驗室;
【分類號】：R512.62

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