抗HCV治疗后HBV再激活的机制与临床意义研究进展  

Mechanism and clinical significance of HBV reactivation after anti-HCV therapy

作　　者：曾婉嘉 高林 徐艺玮 陈香梅 王福生[2,3] 鲁凤民 Zeng Wanjia;Gao Lin;Xu Yiwei;Chen Xiangmei;Wang Fusheng;Lu Fengmin(Department of Microbiology&Infectious Disease Center,School of Basic Medical Sciences,Peking University Health Science Center,Beijing 100191,China;Peking University 302 Clinical Medical School,Beijing 10039,China;Treatment and Research Center for Infectious Diseases,the Fifth Medical Centre of Chinese PLA(People's Liberation Army)General Hospital,Beijing 100039,China;Hepatology Institute,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学医学部基础医学院病原生物学系暨感染病研究中心,北京100191 [2]北京大学三〇二临床医学院,北京100039 [3]解放军总医院第五医学中心感染性疾病诊疗与研究中心,北京100039 [4]北京大学人民医院肝病研究所,北京100044

出　　处：《中华肝脏病杂志》2022年第9期997-1001,共5页Chinese Journal of Hepatology

基　　金：“十三五”国家科技重大专项(2017ZX10202202,2017ZX10202203)。

摘　　要：丙型肝炎病毒(HCV)和乙型肝炎病毒(HBV)合并感染患者在接受直接抗丙型肝炎病毒药物(DAAs)治疗后,可有效抑制HCV复制并实现丙型肝炎治愈,但存在HBV再激活风险,后者可导致严重肝损伤甚至暴发性肝炎的发生。现对HCV和HBV在肝细胞中的复制特点以及激活天然免疫应答的差异进行了总结,探讨了DAAs治疗后发生HBV再激活的分子机制及其临床意义,并提出了相应的临床预防措施。Direct-acting antivirals(DAAs)can strongly inhibit the replication of hepatitis C virus(HCV)and effectively clear the infection,but it may cause hepatitis B virus(HBV)reactivation,leading to severe liver damage and fulminate hepatitis in patients with HCV/HBV coinfection.In this review,we summarized the different replication process of HCV and HBV in infected hepatocytes and consequent innate immune response,and then discussed the molecular mechanism and clinical significance of HBV reactivation,and put forward the clinical precaution.

关 键 词：丙型肝炎病毒 乙型肝炎病毒 干扰素 直接抗丙型肝炎病毒药物 再激活 

分 类 号：R512.63[医药卫生—内科学]