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[乙型肝炎病毒(HBV)感染的血清标志物与慢性HBV感染的自然史]

[The serum markers of hepatitis B virus (HBV) infection and the natural history of chronic HBV infection].

作者信息

Chen Yuan-sheng, Liang Xiao-feng, Hu Jun-feng

机构信息

Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

出版信息

Zhongguo Yi Miao He Mian Yi. 2009 Jun;15(3):279-83.

Abstract

The serum markers of hepatitis B virus (HBV) infection are complex, mainly including HBV surface antigen (HBsAg) and antibody to HBsAg, HBV e antigen (HBeAg) and antibody to HBeAg, antibody to HBV core antigen. The natural history of chronic HBV infection is complex and variable and greatly influenced by the age of infection, the level of HBV replication, HBV genotype and mutations, presence of HBeAg, ALT level, coinfection with HCV and/or HDV, host immune status. Four stages of chronic HBV infection are the immune tolerant phase, the immune clearance phase, the low or non-replicative phase, and the reactivation phase. Some patients with HBeAg positive, high level of ALT and HBV DNA>105 copies/mL would develop liver-related complications, such as cirrhosis, hepatocellular carcinoma and liver failure. Available evidences indicate that control of HBV replication with antiviral drugs can decrease the incidence of these complications and mortality.

摘要

乙型肝炎病毒(HBV)感染的血清标志物较为复杂,主要包括HBV表面抗原(HBsAg)及其抗体、HBV e抗原(HBeAg)及其抗体、HBV核心抗原抗体。慢性HBV感染的自然史复杂多变,受感染年龄、HBV复制水平、HBV基因型和突变、HBeAg的存在、ALT水平、HCV和/或HDV合并感染、宿主免疫状态的影响很大。慢性HBV感染分为四个阶段,即免疫耐受期、免疫清除期、低复制或非复制期和再激活期。一些HBeAg阳性、ALT水平高且HBV DNA>105拷贝/mL的患者会出现肝脏相关并发症,如肝硬化、肝细胞癌和肝衰竭。现有证据表明,使用抗病毒药物控制HBV复制可降低这些并发症的发生率和死亡率。

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