A critical review of the prospects and challenges of Hepatitis B therapeutic vaccines

S. Hudu, Amira Osman, Esra’a Jebreel Ibrahim Abu-Shoura, A. Jimoh
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Abstract

Hepatitis B therapeutic vaccines hold great promise in the treatment of chronic Hepatitis B virus (HBV) infection. However, like any medical intervention, they also face certain prospects and challenges which forms the aim of this critical review. Therapeutic vaccines offer a targeted approach to manage chronic Hepatitis B infections, aiming to stimulate the immune system to recognise and eliminate infected cells. The potential to halt disease progression holds promise for preventing severe liver diseases associated with chronic Hepatitis B, such as cirrhosis and hepatocellular carcinoma. Therapeutic vaccines, if effective, could contribute to a more equitable distribution of treatment options globally, especially in resource-limited settings. Hepatitis B therapeutic vaccines may play a crucial role in preventing vertical transmission, reducing the global incidence of perinatal HBV infections and improving maternal-child health outcomes. Diverse vaccine platforms and combination strategies, including immunomodulation and checkpoint inhibitors, are advancing, optimising immunogenicity, and eliciting strong immune responses. Tailoring therapeutic vaccines to individual patients based on genetic considerations may enhance efficacy, recognizing the genetic diversity of Hepatitis B. Therapeutic vaccines need to align with global health goals related to infectious disease elimination, contributing to broader efforts to reduce the burden of Hepatitis B worldwide. While Hepatitis B therapeutic vaccines hold significant promise in transforming the management of chronic infections, addressing challenges related to access, viral variability, and long-term monitoring is crucial for their successful integration into global healthcare strategies.
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乙型肝炎治疗性疫苗的前景与挑战评述
乙型肝炎治疗疫苗在治疗慢性乙型肝炎病毒(HBV)感染方面大有可为。然而,与任何医疗干预措施一样,它们也面临着某些前景和挑战,这正是本评论的目的所在。治疗性疫苗为控制慢性乙型肝炎感染提供了一种有针对性的方法,旨在刺激免疫系统识别并消除受感染的细胞。阻止疾病进展的潜力为预防与慢性乙型肝炎相关的严重肝病(如肝硬化和肝细胞癌)带来了希望。治疗性疫苗如果有效,将有助于在全球范围内更公平地分配治疗方案,尤其是在资源有限的环境中。乙肝治疗性疫苗可在预防垂直传播、降低全球围产期 HBV 感染率和改善母婴健康状况方面发挥关键作用。包括免疫调节和检查点抑制剂在内的多种疫苗平台和组合策略正在取得进展,优化了免疫原性,并激发了强烈的免疫反应。治疗性疫苗需要与消除传染病的全球健康目标保持一致,为减轻全球乙肝负担的更广泛努力做出贡献。虽然乙型肝炎治疗性疫苗在改变慢性感染管理方面大有可为,但要将其成功纳入全球医疗保健战略,解决与获取、病毒变异性和长期监测相关的挑战至关重要。
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