Current Concepts of HBV/HCV Coinfection: Coexistence, but Not Necessarily in Harmony.
Current Concepts of HBV/HCV Coinfection: Coexistence, but Not Necessarily in Harmony.
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DOI：
10.1007/s11901-010-0060-4
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发表时间：
2010-01-01
期刊：
影响因子：
--
通讯作者：
Lau, Daryl T-Y
中科院分区：
文献类型：
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作者：
Jamma, Shailaja;Hussain, Ghazi;Lau, Daryl T-Y
B型肝炎和丙型肝炎是全球慢性肝病的重要原因。虽然HBV/HCV合并感染并不少见，但其流行病学定义不明确。大量研究提供证据表明，合并感染加速肝病进展并增加肝细胞癌的风险。通过应用新的细胞培养模型来检查两种病毒的相互作用，研究人员得出结论，HBV和HCV在同一肝细胞中复制而不受干扰。先天免疫和适应性免疫在决定病毒复制和疾病结果中的作用仍需严格的研究。迄今为止，尚无HBV/HCV合并感染的标准治疗建议。聚乙二醇干扰素和利巴韦林联合治疗在抑制合并感染和HCV单一感染的HCV RNA方面表现出相似的疗效。然而，治疗期间HBV再激活可能是一个挑战。未来的临床试验评估添加核苷/核苷酸类似物的选择性HBV/HCV合并感染的患者是成功管理HBV/HCV合并感染的关键。
Hepatitis B and hepatitis C are important causes of chronic liver disease globally. Although HBV/HCV coinfection is not uncommon, its epidemiology is poorly defined. Numerous studies provided evidence that coinfection accelerates liver disease progression and increases the risk of hepatocellular carcinoma. By applying new cell culture models to examine the interaction of both viruses, investigators concluded that HBV and HCV replicate in the same hepatocyte without interference. The roles of innate and adaptive immunity in determining the viral replication and disease outcomes still need rigorous investigation. To date, no standard-of-care recommendation exists for HBV/HCV coinfection. Pegylated interferon and ribavirin combination therapy demonstrated similar efficacy in suppressing HCV RNA in coinfection and HCV monoinfection. However, HBV reactivation during therapy can be a challenge. Future clinical trials evaluating the addition of a nucleoside/nucleotide analog for selective patients with HBV/HCV coinfection are essential for successful management of HBV/HCV coinfection.