Immuntherapien zur Behandlung der chronischen Hepatitis-B-Virusinfektion – eine Übersicht unter besonderer Berücksichtigung von CAR-T-Zellen

More than 250 million people worldwide suffer from chronic infection with hepatitis B virus (CHB). Chronic infection is associated with an increased risk of developing liver fibrosis/cirrhosis and hepatocellular carcinoma. Approximately 0.8–1 million people die annually as a result of CHB. One difficulty in the treatment of CHB is that the viral genome can persist for a very long time in the form of a minichromosome, and viral sequences can insert themselves into the host genome. Chronic infections are often characterized by functional defects of the cellular immune response, especially the T‑cell response, which prevents the elimination of HBV-infected cells. Immunotherapies aiming to cure CHB therefore aim to restore the antiviral function of the cellular immune response. In this review, various current approaches to immunotherapy of CHB are described, in particular the use of genetically modified autologous T cells as a possible tool for therapy. Furthermore, the modulation of checkpoint inhibitors of the immune response, metabolic T cell therapies, and therapeutic vaccination to stimulate the T‑cell response are summarized as immunotherapeutic strategies for treating CHB.