儿童HBV感染:ALT水平正常患儿的抗病毒治疗  

Hepatitis B virus infection in children:Antiviral therapy for children with a normal alanine aminotransferase level

作　　者：傅蕾[1] FU Lei(Department of Infectious Diseases,Xiangya Hospital of Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院感染病科,长沙410008

出　　处：《临床肝胆病杂志》2024年第5期870-874,共5页Journal of Clinical Hepatology

摘　　要：慢性乙型肝炎(CHB)是全球范围内的重大公共卫生问题,目前我国约有200万儿童HBV感染者。儿童感染HBV后更容易慢性化,成年后发生肝硬化以及肝癌的风险高。传统观点认为儿童HBV感染多数处于免疫耐受期,无需考虑抗病毒治疗,仅对免疫活动期和代偿期或失代偿期肝硬化的儿童CHB启动抗病毒治疗。越来越多的儿童CHB临床研究结果显示,儿童CHB抗病毒治疗(特别是以干扰素为基础的方案)应答率高,低龄儿童是临床治愈的优势人群,但对于ALT水平正常,特别是处于免疫耐受期的HBV感染的患儿是否接受抗病毒治疗仍然存在争议。本文针对儿童HBV感染的特点及ALT水平正常患儿抗病毒治疗必要性,特别是关于治疗时机等方面进行综述。Chronic hepatitis B(CHB)is a major public health issue around the world,and there are currently about 2 million children with hepatitis B virus(HBV)infection in China.HBV infection in children tends to become chronic,leading to high risks of liver cirrhosis and liver cancer in adulthood.Traditionally,it is believed that children with HBV infection are mainly in the immune-tolerant phase and do not require antiviral therapy,and antiviral therapy is only initiated for CHB children who are in the immune-active phase or suffer from compensated or decompensated liver cirrhosis.More and more clinical studies on CHB in children have shown that CHB children tend to have a high response rate to antiviral therapy,especially interferon-based regimens,and young children are at the advantage of clinical cure;however,there are still controversies over whether antiviral therapy should be initiated for children with HBV infection who have a normal alanine aminotransferase(ALT)level and are in the immune-tolerant phase.This article reviews the features of children with HBV infection and the necessity of antiviral therapy for children with a normal ALT level,with a special focus on treatment timing.

关 键 词：乙型肝炎病毒 丙氨酸转氨酶 治疗学 儿童 

分 类 号：R725.1[医药卫生—儿科]