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干扰素(IFN)_α是目前治疗慢性乙型肝炎(CHB)的主要药物之一,具有广谱抗病毒和免疫调节两方面的作用,可抑制病毒DNA复制和RNA合成,促进病毒RNA降解,抑制病毒蛋白的合成和转运及病毒颗粒的成熟和分泌,能促进人类白细胞抗原Ⅰ、Ⅱ类分子的表达及增强CTL、APC和NK细胞等的活性。及时应用IFN_α治疗,对于机体阻断HBV感染的慢性化以及随后的病程进展具有积极的疗效,且用改良后的新一代聚乙二醇_IFN_α(PEG_IFN_α)治疗CHB患者,取得了更加不错的疗效。然而,IFN_α有较严格的适应征,其治疗CHB的总有效率至今不超过40%。许多研究表明,HBV的基因型、特定的环境因素和人体的遗传因素是影响IFN_α疗效的主要因素。要提高IFN_α的治疗效果,就必须对以上各影响因素的分子机制进行研究,以改善疗效,指导未来临床合理化或个体化用药。
Interferon (IFN) alpha is one of the main drugs in the treatment of chronic hepatitis B (CHB). It has a broad spectrum of antiviral and immunomodulatory effects and can inhibit viral DNA replication and RNA synthesis, promote the degradation of viral RNA, The synthesis and transport of viral proteins and the maturation and secretion of virus particles promote the expression of human leukocyte antigen class I and class II molecules and enhance the activity of CTL, APC and NK cells. The timely application of IFN-α therapy has a positive effect on the chronicity of the body’s blocking of HBV infection and the subsequent course of the disease, and has achieved a more good curative effect with a newer generation of PEG_IFN_α . However, IFN_α has more stringent indications and its total effective rate of treating CHB has not exceeded 40% so far. Many studies have shown that HBV genotypes, specific environmental factors and human genetic factors are the main factors that affect the efficacy of IFN-α. To improve the therapeutic effect of IFN-α, we must study the molecular mechanism of the above factors in order to improve the curative effect and guide clinical rationalization or individualized medication in the future.