酒精协同乙肝病毒促进肝硬化的研究进展

Research progress of the synergy between alcohol and hepatitis B virus in promoting cirrhosis

慢性乙型肝炎病毒患者合并饮酒正逐年增多,对于酒精是否增加慢性乙肝患者进展至肝硬化的风险,以及乙肝病毒和酒精之间的相互作用机制都值得去探索。酒精增加HBV的复制、增加机体氧化应激、减弱机体对病毒的免疫反应,促进肝星状细胞激活产生过量的细胞外基质从而促进肝硬化的进展。临床研究表明不同的饮酒量会对慢性乙肝患者疾病进展产生不同的影响,轻度到中度饮酒不会增加慢性乙肝患者进展为肝硬化的风险,而重度饮酒会促进慢性乙肝患者进展为肝硬化,且会降低机体对干扰素的反应导致病毒难以被清除。故通过酒精协同乙肝病毒促进肝硬化的研究有助于公众加强酒精对慢性乙型病毒性肝炎疾病进展的认识,并为慢性乙肝患者戒酒等生活方式的干预提供更多的研究证据支持。

Chronic hepatitis B virus patients’ combined alcohol consumption is increasing year by year. Whether alcohol increases the risk of chronic hepatitis B patients progressing to liver cirrhosis, and the synergy mechanism between hepatitis B virus and alcohol are worth being explored. Alcohol can increase the replication of HBV, increase the body’s oxidative stress response, weaken the body’s immune response to HBV, and promote the activation of liver stellate cells to produce excess extracellular matrix to promote the progression of liver cirrhosis. Clinical researches have shown that different levels of alcohol consumption can have different effects on the progression of chronic hepatitis B patients. Mild to moderate alcohol consumption does not increase the risk of chronic hepatitis B patients progressing to cirrhosis, while heavy alcohol consumption may promote chronic hepatitis B patients to progress to cirrhosis, and will reduce the body’s response to interferon, making the virus difficult to be cleared out. Therefore, the study of alcohol and HBV promoting liver cirrhosis will help the public to strengthen the understanding of alcohol on the progress of liver cirrhosis, and provide more research evidence for lifestyle intervention such as alcohol abstinence in patients with chronic hepatitis B.