与直接抗病毒药物应用相关的HCV/HBV双重感染的特点及其诊治管理

Features and management of patients with hepatitis C virus/hepatitis B virus dual infection associated with the application of direct-acting antiviral agents

HCV和HBV的双重感染(DI)具有不同于单一HCV或HBV感染的特殊临床、免疫学和病毒学特点,为临床诊治和管理带来了诸多挑战。在应用直接抗病毒药物(DAA)有效控制HCV感染的同时,可能导致HBV的激活和乙型肝炎的发作甚至肝衰竭。在抗HCV治疗的同时,根据不同的HCV/HBV-DI状态选用合适的抗HBV治疗和随访管理策略至关重要。

Dual infection with hepatitis C virus（HCV） and hepatitis B virus（HBV） has significantly different clinical,immunological,and virological features from single infection with HCV or HBV,which brings various challenges to clinical diagnosis/treatment and management.Direct-acting antiviral agents used for effective control of HCV infection may cause HBV activation,onset of hepatitis B,and even liver failure.Therefore,during the antiviral treatment of HCV infection,it is of great importance to select appropriate anti-HBV therapy and follow-up management strategies based on the status of HCV/HBV dual infection.