Multiple new therapeutic approaches are currently being developed to achieve sustained, off-treatment suppression of HBV, a persistent hepatotropic infection that kills ~2,000 people a day. A fundamental therapeutic goal is the restoration of robust HBV-specific adaptive immune responses that are able to maintain prolonged immunosurveillance of residual infection. Here, we provide insight into key components of successful T cell and B cell responses to HBV, discussing the importance of different specificities and effector functions, local intrahepatic immunity and pathogenic potential. We focus on the parallels and interactions between T cell and B cell responses, highlighting emerging areas for future investigation. We review the potential for different immunotherapies in development to restore or release endogenous adaptive immunity by direct or indirect approaches, including limitations and risks. Finally, we consider an alternative HBV treatment strategy of replacing failed endogenous immunity with infusions of highly targeted T cells or antibodies.

目前正在开发多种新的治疗方法，以实现对 HBV 的持续、治疗外抑制，HBV 是一种持续性嗜肝性感染，每天会导致约 2,000 人死亡。一个基本的治疗目标是恢复强大的 HBV 特异性适应性免疫反应，从而能够维持对残留感染的长期免疫监视。在这里，我们深入了解 T 细胞和 B 细胞对 HBV 成功反应的关键组成部分，讨论不同特异性和效应器功能、局部肝内免疫和致病潜力的重要性。我们重点关注 T 细胞和 B 细胞反应之间的相似性和相互作用，强调未来研究的新兴领域。我们回顾了正在开发的不同免疫疗法通过直接或间接方法恢复或释放内源性适应性免疫的潜力，包括局限性和风险。最后，我们考虑另一种 HBV 治疗策略，即通过输注高度靶向的 T 细胞或抗体来替代失败的内源性免疫。