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The high prevalence of the hepatitis B virus (HBV) in population occurs mainly due to numerous mechanisms formed in the process of the virus evolution, contributing to its survival under immunological pressure. The review presents the most complete systematization and classification of various HBV protective mechanisms basing on their influence on different parts of congenital and adaptive immune response. The analysis of literature data allows for the conclusion that two basic principles underlie the mechanisms: the strategy of the «stealth virus» (virus’s escape from recognition by the immune system) and strategy of immunosuppression. The stealth virus strategy is performed as follows: special strategy of the HBV replication which prevents the recognition by the receptors of congenital immune system; occurrence of the vaccine escape mutants; isolation of the virus in host cells and tissues providing its inaccessibility to T-cells along with hyperproduction of subviral particles as traps for specific antibodies. The core principle of the immunosuppression implemented in hepatitis B therapy is based on the phenomenon of the viral apoptotic mimicry. The result of this interaction strategy is dysfunction of NK and NKT-cells, inactivation of dendritic cell functions, and suppression of the adaptive immune response. The review demonstrates that interaction between HBV and the immune system of the macro organism is in some kind of «dynamic equilibrium» depending on numerous factors. Specific molecular targets of the viral impact are described. We propose to expand the research on the influence of the host’s genetic factors on the development of congenital and adaptive immune response against HBV, especially during the real infectious process which results in the improvement of approaches to the therapy by developing personalized treatment methods.

About the authors

M. V. Sokolova

N.F. Gamaleya Federal Research Centre of Epidemiology and Microbiology

ORCID iD: 0000-0002-2836-8232
Moscow Russian Federation

M. V. Konopleva

N.F. Gamaleya Federal Research Centre of Epidemiology and Microbiology

ORCID iD: 0000-0002-9724-695X
Moscow Russian Federation

Т. A. Semenenko

N.F. Gamaleya Federal Research Centre of Epidemiology and Microbiology

ORCID iD: 0000-0002-6686-9011

V. G. Akimkin

Central Research Institute of Epidemiology

ORCID iD: 0000-0001-8139-0247
Moscow Russian Federation

A. V. Tutelyan

Central Research Institute of Epidemiology

Author for correspondence.
ORCID iD: 0000-0002-2706-6689
Moscow Russian Federation

A. P. Suslov

N.F. Gamaleya Federal Research Centre of Epidemiology and Microbiology

ORCID iD: 0000-0001-5731-3284
Moscow Russian Federation


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