Fonseca José Carlos Ferraz da
Faculdade de Ciências da Saúde, Universidade Federal do Amazonas, Manaus, AM.
Rev Soc Bras Med Trop. 2007 Nov-Dec;40(6):672-7. doi: 10.1590/s0037-86822007000600015.
An estimated 350 million people worldwide are chronically infected with hepatitis B virus (HBV). Three phases of chronic hepatitis B virus infection is are recognized: the immune tolerant phase (HBeAg-positive, high levels of serum HBV-DNA, normal ALT, and no evidence of active liver diseases), the immune clearance phase or chronic hepatitis phase (HBeAg-positive, high levels of serum HBV-DNA, elevated ALT, and active liver disease ), and the inactive carrier state or asymptomatic phase (HBsAg-positive in serum without HBeAg, HBV-DNA levels than < 10(5) copies/mL, and normal ALT levels). Chronic hepatitis B is classified into 2 major forms: HBeAg-positive disease (wild-type HBV) and HBeAg negative disease (pre-core/core promoter HBV variant). Both forms can lead to liver cirrhosis, hepatic decompensation and liver cancer. The purpose of this article is to review the principal aspects of natural history of chronic hepatitis B.
据估计，全球约有3.5亿人慢性感染乙肝病毒（HBV）。慢性乙肝病毒感染分为三个阶段：免疫耐受期（HBeAg阳性，血清HBV-DNA水平高，ALT正常，无活动性肝病证据）、免疫清除期或慢性肝炎期（HBeAg阳性，血清HBV-DNA水平高，ALT升高，有活动性肝病）以及非活动性携带者状态或无症状期（血清HBsAg阳性但无HBeAg，HBV-DNA水平低于10⁵拷贝/mL，ALT水平正常）。慢性乙型肝炎主要分为两种形式：HBeAg阳性疾病（野生型HBV）和HBeAg阴性疾病（前核心/核心启动子HBV变异体）。这两种形式均可导致肝硬化、肝功能失代偿和肝癌。本文旨在综述慢性乙型肝炎自然史的主要方面。
