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免疫功能正常和免疫功能低下宿主中的巨细胞病毒性肝炎

Cytomegalovirus Hepatitis in Immunocompetent and Immunocompromised Hosts.

作者信息

Da Cunha Teresa, Wu George Y

机构信息

Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, CT, USA.

Current address: Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA.

出版信息

J Clin Transl Hepatol. 2021 Feb 28;9(1):106-115. doi: 10.14218/JCTH.2020.00088. Epub 2021 Jan 4.

Abstract

Human cytomegalovirus (HCMV) infection is common and affects between 40-100% of the worldwide population. However, the majority of cases are asymptomatic and when severe disease occurs, it is usually restricted to immunocompromised patients. Liver involvement by HCMV differs significantly, accordingly to the immune status of the host. In immunocompromised patients, particularly liver transplant patients, it often causes clinically significant hepatitis. On the other hand, in immunocompetent patients, HCMV hepatitis requiring hospitalization is extremely rare. This review aims to appraise studies regarding the pathophysiology of HCMV hepatitis, including mechanisms of latency and reactivation and its contribution to disease development, clinical presentation, diagnostic modalities and treatment, with a focus on comparing different aspects between immunocompromised and immunocompetent hosts.

摘要

人巨细胞病毒(HCMV)感染很常见,全球40%-100%的人口受其影响。然而,大多数病例无症状,当出现严重疾病时,通常仅限于免疫功能低下的患者。HCMV所致的肝脏受累因宿主免疫状态的不同而有显著差异。在免疫功能低下的患者中,尤其是肝移植患者,HCMV常引起具有临床意义的肝炎。另一方面,在免疫功能正常的患者中,需要住院治疗的HCMV肝炎极为罕见。本综述旨在评估有关HCMV肝炎病理生理学的研究,包括潜伏和再激活机制及其对疾病发展的影响、临床表现、诊断方法和治疗,重点比较免疫功能低下和免疫功能正常宿主之间的不同方面。

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