慢性HBV感染与代谢相关脂肪性肝病:已知与未知

Chronic hepatitis B virus infection and metabolic associated fatty liver disease:The known and unknown aspects

慢性HBV感染是全球病毒性肝炎疾病负担的主要原因。由于生活方式和饮食习惯的改变,代谢相关脂肪性肝病(MAFLD)的发病率不断上升,已成为全球第一大慢性肝病。慢性HBV感染合并MAFLD在临床上越来越常见,代谢因素而非病毒因素是慢性HBV感染合并MAFLD的主要原因。在疾病发展进程中,炎症、纤维化而非脂肪变性是合并患者发展为肝硬化、肝细胞癌的主要影响因素。对于慢性HBV感染和MAFLD同时存在的患者,抗病毒和代谢因素的联合管理至关重要。本文就慢性HBV感染合并MAFLD的相互作用、预后转归和临床管理等热点话题进行讨论。

Chronic hepatitis B virus(HBV)infection is the main cause of the disease burden of viral hepatitis worldwide,and meanwhile,due to changes in lifestyle and dietary habits,the incidence rate of metabolic associated fatty liver disease(MAFLD)is constantly increasing,making MAFLD the leading chronic liver disease around the world.Chronic HBV infection comorbid with MAFLD is becoming more and more common in clinical practice.Metabolic factors,rather than viral factors,are the main cause of chronic HBV infection comorbid with MAFLD.During disease progression,steatohepatitis and fibrosis,rather than steatosis,are the main influencing factors for the progression to liver cirrhosis and hepatocellular carcinoma.For patients with chronic HBV infection and MAFLD,integrated management of virus and metabolic factors is of great importance.This article reviews the tissues regarding the interaction,prognosis,and clinical management of chronic HBV infection and MAFLD.