Human monoclonal antibodies as adjuvant treatment of chronic hepatitis B virus infection.
- 1San Matteo Hospital Foundation (IRCCS), Italy
- 2University of Pavia, Italy
Despite the availability of an effective prophylactic vaccine leading to sterilizing immunity, hepatitis B virus (HBV) is responsible for chronic liver disease in more than 250 million individuals, potentially leading to cirrhosis and primary liver cancer. Antiviral drugs able to completely suppress virus replication are indeed available but they are by and large unable to eradicate the virus. Several alternative new treatment approaches are currently being developed but none has so far captured the interest of clinicians for possible clinical development. A constant feature of chronic HBV infection is T-cell exhaustion resulting from persistent exposure to high antigen concentrations as shown by the high expression of programmed cell death protein 1 (PD-1) by HBV-specific CD8 T cells. One way of tackling this problem is to develop HBV-specific neutralizing antibodies that would clear excess envelope proteins from the circulation, allowing for nucleos(t)ide analogs or other antiviral drugs now in preclinical and early clinical development to take advantage of a reconstituted adaptive immunity. Several fully human monoclonal antibodies (mAb) have been developed from HBV-vaccinated and subjects convalescent from acute hepatitis B that show different properties and specificities. It is envisaged that such neutralizing mAb may be used as adjuvant treatment to reduce viral protein load, thus rescuing adaptive immunity in an effort to optimize the effect of antiviral drugs.
Keywords: Human monoclonal antibody, HBV - hepatitis B virus, B cells, Immune System, Adaptive Immunity
Received: 03 Jul 2019;
Accepted: 10 Sep 2019.
Copyright: © 2019 Cerino, Mantovani, Mele, Oliviero, Varchetta and Mondelli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mx. Mario U. Mondelli, University of Pavia, Pavia, Italy, firstname.lastname@example.org