丙氨酸转氨酶正常的慢性乙型肝炎病毒感染人群抗病毒治疗策略

Anti-virus treatment strategies for chronic hepatitis B virus infection with normal alanine aminotransferase

在中国慢性乙型肝炎病毒(HBV)感染的主要途径是母婴垂直传播或幼年期感染,因此疾病的自然史中存在免疫耐受的特殊状态。在临床上常常表现为HBV DNA高水平、乙型肝炎病毒e抗原(HBeAg)阳性和丙氨酸转氨酶(ALT)正常,肝组织没有或仅有轻微的炎症。对于这些ALT正常的慢性HBV感染人群抗病毒治疗的问题一直是临床研究的热点。文章从ALT与HBV感染的关系、哪些ALT正常的慢性HBV感染者应该抗病毒治疗及抗病毒治疗的可行性加以阐述。

In China,chronic HBV transmits mainly by vertical transmission or infects during childhood. Clinically some patients may remain HBeAg positive with high levels of serum HBV DNA, little or no symptoms, normal alanine aminotransferase （ALT） levels,and mi｜d or no inflammations of liver tissue, and this phenomenon is known as the immune tolerance phase. Anti-virus treatment of these patients has always been a hotspot in clinical research. In this paper, we discussed the correlation between ALT and HBV infection,indications of anti-virus treatments in those with normal ALT and advantages of anti-virus treatments.