Duan M H, Liu X E, Zhuang H
Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China.
Zhonghua Gan Zang Bing Za Zhi. 2021 Mar 20;29(3):284-288. doi: 10.3760/cma.j.cn501113-20200629-00352.
Patients in "immunotolerant phase" of chronic hepatitis B virus infection are HBsAg and HBeAg-positive, with high HBV DNA level, normal ALT and no obvious histopathological hepatic necrotizing inflammation or fibrosis. However, in recent years, some studies have found that HBV DNA integration, clonal hepatocyte expansion, HBV-specific T cell immune response, liver injury and disease progression exist in patients with "immunotolerant phase" of chronic HBV infection. Therefore, the concept of "immunotolerant phase" is controversial. This paper summarizes the new insights into the "immunotolerant phase" of chronic hepatitis B virus infection, including its new concepts in nomenclature, diagnosis, treatment and management.
慢性乙型肝炎病毒感染“免疫耐受期”的患者HBsAg和HBeAg呈阳性,HBV DNA水平高,ALT正常,且无明显的组织病理学肝坏死性炎症或纤维化。然而,近年来一些研究发现,慢性HBV感染“免疫耐受期”的患者存在HBV DNA整合、克隆性肝细胞增殖、HBV特异性T细胞免疫反应、肝损伤及疾病进展。因此,“免疫耐受期”的概念存在争议。本文总结了慢性乙型肝炎病毒感染“免疫耐受期”的新见解,包括其在命名、诊断、治疗及管理方面的新概念。