乙型肝炎病毒再激活致慢加急性肝衰竭研究进展

Research advances in acute-on?chronic liver failure (ACLF) with reactivation of hepatitis B virus

乙型肝炎病毒(hepatitis B virus,HBV)再激活导致慢加急性肝衰竭治疗困难、病死率高,近年发病率逐年增高。B细胞单克隆抗体、糖皮质激素、化疗、直接抗丙型肝炎病毒药物及自行停用核苷(酸)类似物抗HBV治疗等,均是引起HBV再激活的高危因素。本文从HBV再激活的诊断标准、危险因素、发生慢加急性肝衰竭的风险评估及其预防和管理等方面进行综述。

The acute-on-chronic liver failure (ACLF) with reactivation of hepatitis B virus (HBV)leads to the difficulty in the treatment and the high mortality rate,but the incidence of HBV reactivation is increasing year by year.There are some high risk factors for the reactivation of HBV,such as the use of rituxan,the glucocortieoid,the chemotherapy,the direct-acting antiviral drugs against hepatitis C virus (HCV) and stopping the nucleot(s) ides analogues against HBV by oneself.The diagnostic criteria,risk factors,risk assessment of ACLF,prevention and management of HBV reactivation are reviewed in this article.