HBV感染自然史研究进展

Advance in the natural history of hepatitis B virus infection

病毒复制与宿主免疫之间的动态平衡在HBV感染自然史进展和发病机制中起重要作用。多数免疫能力正常的成人感染HBV后呈自限性,而在婴幼儿则多发展成为慢性HBV感染。慢性HBV感染分为4期:免疫耐受期、HBeAg阳性慢性肝炎期、非复制的HBsAg携带期和HBeAg阴性慢性肝炎期。HBV DNA水平、HBeAg的状态以及ALT水平可以预测HBV感染的长期结局如肝硬化或肝细胞癌。本文对HBV感染自然史分期、慢性HBV感染的结局和预后进行了综述。

The dynamic balance between viral replication and the host immune response plays a key role in the natural history and pathogenesis of hepatitis B virus infection. Most infections in immunocompetent adults are self-limited, whereas most infants develop chronic HBV infection. Chronic HBV infection may present in four phases： immune toler- ance, HBeAg-positive chronic hepatitis, non-replicative HBsAg carriers and HBeAg-negative chronic hepatitis. Several risk factors, such as HBV DNA levels, HBeAg status, and ALT levels, have been identified to predict the long-term out-come, including cirrhosis and HCC. Stages of the natural history of HBV infection, outcome and prognosis of chronic HBV infection are reviewed in this paper.