基于大规模双向队列人群的乙肝病毒再激活特征及其机制研究

随着乙肝疫苗普及接种，新发乙肝病毒（HBV）感染控制已取得明显成效。但广大HBsAg长期携带者和现症感染者的防治却面临诸多困难，HBV再激活就是其中一个十分重要并极具挑战的问题。因为大多HBV再激活病例呈亚临床现象，直到发展为严重的进展性肝病才会受到重视和就医。同时随着再激活，HBV无症状携带者的传染性也会很大增强，带来严重的公共卫生问题。本课题将利用2009年在我国乙肝防治示范区-甘肃省武威市凉州区两个乡镇建立的2.1万基线队列人群，进行历史性和前瞻性双向队列研究，通过2009年-2018年的十年动态监测，获得社区人群HBV再激活的发病密度和相对危险度等重要指标，揭示病毒学、临床和流行病学特征，查明自然史，并探索发生发展的分子机制，提出普通人群中HBV再激活高危个体的全新筛检方案，为人群中HBV无症状感染者启动抗病毒预防的时机提供针对性的指导意见。这必将有力地推动我国乙肝的防控工作。

Along with the universal vaccination of hepatitis B vaccine,the control of new hepatitis B virus (HBV) infection has got a obvious success. But we still face many problems in prevention and treatment for HBsAg carrier and current HBV infection, and HBV reactivation is just one of the very important challenges needing to be addressed. The most patients of HBV reactivation manifest a sub-clinical phenomenon, and not easy to be detected and pay more attention untill they have a severe liver damage to see doctor. In the same time, those patients could be as a surce of infection in family and community, and bring to a public health issue. The project will utilize a cohort population of 21 thousands constructed in 2 towns in Wuwei City, Gansu Province of National Hepatitis B Prevention and Treatment Demonstration Area in 2009,to do a historical prospective cohort study. Through 10 years dynamic surveillance from 2009 to 2018, we hope to clear of incidence rate, the charecteristics of virology, clinical manifestationand epidemiology,to find out natural history, and to explore the molecular mechanisms of HBV reactivation occurrence and development. From the research, we will put forward to screen methods and technical roadmap for early detecting high risk individual of HBV reactivation in general population, and provide a detail guideline for starting use of antiviral medicine to prevent reactivation, which will vigorously promote hepatitis B prevention and control in our country.