Immunology of Viral Hepatitis and Infections in Liver Cirrhosis

Infections with hepatitis viruses A-E are a global health burden. Acute infections with hepatitis viruses B (HBV), C (HCV), D (HDV) or E (HEV) can turn into chronic hepatitis with the sequalae of liver cirrhosis and hepatocellular carcinoma. Word-wide more than 350 million people suffer from chronic viral hepatitis. Meanwhile, chronic hepatitis C can be cured by direct acting antivirals but the impact of HCV cure on the disturbed immune system is not fully understood. Chronic hepatitis B can be controlled by direct antiviral nucelos(t)ide analogues but a complete cure of the infection is rare. New concepts, especially modulation of the immune response against HBV, is an important concept to achieve the goal of HBV cure. Chronic hepatitis D is always a co-infection with HBV and thus concepts to cure HBV will also eliminate HDV. Chronic hepatitis E is unique for immunocompromised patients such as organ transplant recipients because immune competent individuals usually spontaneously resolve acute HEV infection. Thus, a reinvigoration of the impaired immune response against HEV might be an innovative concept to combat chronic hepatitis E in these vulnerable patients. 

Patients with liver cirrhosis, irrespective of the etiology, have an immunocompromised status and are vulnerable to infections. For example, spontaneous bacterial infection of the peritoneal cavity due to ascites is the main reason for progression and decompensation. 

The focus of the research group is the better understanding of immune responses against hepatitis viruses and the development of new concepts to modulate the host immune system to combat chronic viral hepatitis. In addition, the research group investigates the mechanisms of the liver cirrhosis associated immune deficiency and how the immune system can be modulated to improve the survival of these vulnerable patients.