Host immunity influences disease progression and antiviral efficacy in humans infected with hepatitis B virus

Abstract

Hepatitis B virus (HBV) infection can lead to several severe liver diseases, including hepatitis, cirrhosis and hepatocellular carcinoma, although the underlying mechanisms responsible for the clinical outcome have not been well characterized. In this review, we retrospectively examine the history of immunological responses to HBV infection and summarize the current understanding of innate and adaptive immunity in the context of HBV-associated liver disease. Recent data indicate that the interaction between HBV and the host immune response not only substantially drives disease progression, but also significantly influences antiviral efficacy in HBV-infected individuals. Advances in the field have provided insight into the immunopathology of HBV infection. Based on the characteristics of host immune responses in patients with HBV infection, a ‘climbing slope hypothesis’ is proposed to suggest that therapeutic strategies aimed at modulating the immune activity of the host may represent a complementary approach to antiviral drug treatment for the management of chronically HBV-infected patients.

Keywords::

• antiviral therapy
• disease progression
• hepatitis B virus
• host immunity
• immune therapy

Financial & competing interests disclosure

This study was supported by grants from the the National Grand Program on Key Infectious Disease (2009ZX1004–309, 2008ZX10002–007 and 2008ZX10002–005–6), the National Key Basic Research Program of China (No. 2007CB512805, No. 2007CB512804) and the Key Program of National Natural Science Foundation of China (No. 30730088). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.