Natural history of hepatitis B infection
Natural history of hepatitis B infection
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DOI：
10.1016/s0755-4982(06)74576-6
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发表时间：
2006-02-01
期刊：
影响因子：
2.7
通讯作者：
Pol, S
中科院分区：
文献类型：
--
作者：
Pol, S
6型肝炎病毒通过肠道外、性传播和围产期传播。虽然1%的有症状的急性肝炎患者可能会发生暴发性肝炎，但乙肝病毒感染的主要问题是它可能变成慢性的，经典的定义是携带HB表面抗原(HBs)超过6个月。只有0.5%到3%的具有免疫能力的成年人会发生这种情况，但更常见的是儿童(高达90%)和免疫功能低下的患者(30%到100%)。慢性乙肝病毒感染的过程以病毒复制的变化为特征，包括自发的重新激活或终止，以及临床或实验室检测到的潜在恶化。乙肝病毒感染的发病机制主要是免疫介导的，既有宿主与病毒相互作用的结果，也有病毒本身的复杂性(整合、突变、隐蔽复制)。这些因素解释了慢性乙肝感染的各种表现，从免疫耐受到不活跃的携带乙肝表面抗原，经过一个免疫清除阶段，慢性活动性肝炎可能导致肝硬变(年发病率为1.3%至5.9%)。
Hepatitis 6 virus (HBV) is transmitted by parenteral, sexual and perinatal routes.While fulminant hepatitis may occur in 1% of cases of symptomatic acute hepatitis, the principal problem at HBV infection is that it may become chronic, classically defined by carriage of HB surface antigens (HBsAg) for more than 6 months. This occurs in only 0.5 to 3% of immunocompetent adults but more frequently in children (up to 90%) and in immune-compromised patients (30 to 100%). The course of chronic HBV infection is characterized by variations in viral replication with spontaneous reactivation or discontinuation, and potential exacerbations observed clinically or by laboratory testing.The pathogenesis of HBV infection is mainly immune-mediated, resulting from host-virus interactions but also from the complexity of the virus itself (integration, mutation, occult replication). These factors explain the variety of presentations of chronic HBV infection, which range from immune tolerance to inactive carriage of HBsAg, passing through a stage of immune clearance, where chronic active hepatitis which may lead to cirrhosis (yearly incidence of 1.3 to 5.9%).