儿童慢性乙型肝炎免疫耐受期的特点和抗病毒治疗研究进展

Research progress on the characteristics of immune tolerant phase and antiviral therapy in children with chronic hepatitis B

免疫耐受期慢性乙型肝炎(CHB)患儿是否需要治疗是尚未明确的临床热点问题之一。充分了解HBV感染的自然史、与疾病进展的关系以及及时治疗能否改变自然史和预后,对免疫耐受期患儿临床抗病毒治疗的决策非常重要。为此,现对近10年来临床抗病毒治疗免疫耐受期CHB患儿的相关研究进展进行综述。同时,对治疗的安全性、有效性和相关的免疫学机制进行探讨,以期明确下一步的重点研究方向、为肝病专家更好地诊治免疫耐受期儿童CHB患者,提供直接的循证医学证据,最终提高临床治愈率。

Whether or not children with chronic hepatitis B(CHB)in the immune-tolerant phase need to be treated is one of the hot clinical issues that have not yet been clarified.Thus,in order to make clinical antiviral treatment decisions in children with an immune tolerant phase,a comprehensive understanding of the natural history of HBV infection,as well as its relationship with disease progression and whether prompt treatment can alter the natural history and prognosis,is very important.To that end,this article reviews the research progress of clinical antiviral therapy in the immune-tolerant phase for children with chronic hepatitis B over the last decade,while also discussing the treatment's safety,effectiveness,and related immunological mechanisms,so as to clarify the next key step in research orientation,provide direct evidence-based medical evidence for hepatologists to better diagnose and treat,and ultimately improve the clinical cure rate.