Rationale for Designing of Antigen-Specific Immune Therapy Including Dendritic Cell-Based Therapy in Patients with Chronic Hepatitis B Virus Infection

Approximately 350-400 million people of the world are chronically infected with the hepatitis B virus, and it is these individuals that harbor the virus for their whole life and are responsible for its transmission to uninfected populations. Considerable numbers of chronic hepatitis B virus carriers develop progressive liver diseases like chronic hepatitis B, liver cirrhosis and hepatocellular carcinoma. Current treatments for chronic hepatitis B include interferon, and antiviral drugs such as lamivudine, adefovir, and entacavir. These antiviral treatments are not satisfactory in that they are unable to eradicate the hepatitis B virus, expensive, can have debilitating side effects, and, once treatment is stopped, the virus and clinical conditions return in many individuals. Recent advancements in various aspects of cellular and molecular biology indicate that the host's immune responses to the hepatitis B virus play cardinal role during acquisition, pathogenesis, progression and complications of chronic hepatitis B virus infection. These also explain the limitations of antiviral drugs for treatment of these patients. Here, we will first provide a comprehensive account of hepatitis B virus. Next, the scopes and limitations of present regimens of antiviral drugs in chronic HBV carriers will be provided. Finally, the rationale and strategy of immune therapies including dendritic cell-based therapies against chronic hepatitis B virus infection will be discussed.