Cheng Jun-Ya, Shan Guan-Yue, Wan Hui, Liu Yi-Ying, Zhang Yu-Xin, Shi Wen-Na, Li Hai-Jun
Department of Bioengineering, Pharmacy School of Jilin University, Changchun 130061, Jilin Province, China.
Institute of Translational Medicine, The First Hospital of Jilin University, Changchun 130061, Jilin Province, China.
World J Hepatol. 2024 Dec 27;16(12):1515-1523. doi: 10.4254/wjh.v16.i12.1515.
We focus on hepatitis B virus (HBV)-induced cirrhosis, global differences, and the evolution of antiviral treatment strategies. Chronic HBV (CHB) infection affects more than 250 million people globally, leading to cirrhosis and hepatocellular carcinoma. The aim of this article was to synthesize the current understanding of the pathophysiological mechanisms and clinical consequences of HBV-induced cirrhosis, and explore differences in disease progression between geographic regions. Disease progression varies across regions due to differences in HBV subtypes, transmission routes, and immune responses. The challenge of late diagnosis and treatment, particularly in resource-limited areas, highlights the urgency and importance of CHB service expansion. Modern nucleos(t)ide analogues, such as tenofovir and entecavir, have emerged as the main therapeutic regimens to improve clinical outcomes in patients by suppressing viral replication and attenuating liver fibrosis. However, drug resistance challenges highlight the need for ongoing research and personalized treatment strategies. This article highlights the mechanisms and impact of cirrhosis progression in the context of CHB infection, aiming to reduce the incidence of cirrhosis and its serious consequences, thereby improving the long-term health of CHB patients worldwide, especially in Africa.
我们关注乙型肝炎病毒（HBV）引起的肝硬化、全球差异以及抗病毒治疗策略的演变。慢性HBV（CHB）感染在全球影响超过2.5亿人，可导致肝硬化和肝细胞癌。本文旨在综合当前对HBV所致肝硬化的病理生理机制和临床后果的认识，并探讨不同地理区域间疾病进展的差异。由于HBV亚型、传播途径和免疫反应的不同，疾病进展在各地区存在差异。晚期诊断和治疗的挑战，尤其是在资源有限地区，凸显了扩大CHB服务的紧迫性和重要性。现代核苷（酸）类似物，如替诺福韦和恩替卡韦，已成为通过抑制病毒复制和减轻肝纤维化来改善患者临床结局的主要治疗方案。然而，耐药性挑战凸显了持续研究和个性化治疗策略的必要性。本文强调了CHB感染背景下肝硬化进展的机制和影响，旨在降低肝硬化的发病率及其严重后果，从而改善全球尤其是非洲CHB患者的长期健康状况。
