慢性HBV感染合并脂肪肝对疾病进展的影响

Influence of chronic HBV infection complicated with fatty liver on disease progression

慢性HBV感染和非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是慢性肝病常见的原因,同时患有这两种疾病的病人也不少见,明确疾病间的互作影响对指导临床诊疗具有重要意义。本文重点论述了慢性HBV感染合并NAFLD后对各自疾病自然史的影响。近年研究显示,NAFLD中非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)与慢性HBV感染互相恶化,而NAFLD中的脂肪变性与慢性HBV感染的互作影响还存在争议,甚至发现其间存在一定的互相保护作用。但其内在机制尚未明确,还需进一步研究。

Chronic hepatitis B virus infection and non-alcoholic fatty liver disease(NAFLD)are common causes of chronic liver disease,and coexistence of these two disease states is also frequently observed.Clarifying the mutual interactions between these two diseases can guide clinical diagnosis and treatment.This article focused on the effects of chronic HBV infection combined with NAFLD on the natural history of these two diseases.Recent studies showed that non-alcoholic steatohepatitis(NASH)in NAFLD and chronic HBV infection worsened each other,while the interaction between steatosis in NAFLD and chronic HBV infection was controversial,and even a certain mutual protective effect was found in between.However,the internal mechanism has not been clarified and needs to be further studied.