乙型肝炎病毒再激活

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1、乙型肝炎病毒再激活:一个能够预防的问题南昌大学第一附属医院张伦理HBV再激活的发生HepatitisB:SomeSoberingFacts350millionpeoplechronicallyinfected2billionwithevidenceofpastorpresentinfectionCountryoforiginisTHEmajorriskfactorWorldHealthOrganization.HepatitisBFactSheet.CentersforDiseaseControlandPreventi

2、on.CDCHealthInformationforInternationalTravel2012.NewYork:OxfordUniversityPress;2012.PrevalenceofHBsAgHigh≥8%Intermediate2%to7%Low<2%慢性乙肝病毒感染自然史YimHJ,etal.Hepatology.2006;43:S173-S181.HBeAg+HBeAg-HBeAb+ImmuneClearanceImmunotoleranceALTHBVDNAMos-YrsImmuneControl(

3、Nonreplicative)HBsAg+HBsAg-HBsAb+InfectionMos-Yrs5-30YrsYimHJ,etal.Hepatology.2006;43:S173-S181.ImmuneClearanceImmunotoleranceALTHBVDNAMos-YrsHBsAg+HBsAg-HBsAb+InfectionMos-Yrs5-30Yrs慢性乙肝病毒感染自然史MostOncologyPatientsNormalALTLow/undetectableHBVDNAHBsAg+andHBeAg-or

4、HBsAg-,anti-HBc+ImmuneControl(Nonreplicative)HBV能被清除吗?Immunecontrol—notclearance“ResolvedHBV”amisnomer—stillHBVDNAinlivercccDNAWerle-LapostolleB,etal.Gastroenterology.2004;126:1750-1758.HBV能被清除吗?Immunecontrol—notclearance“ResolvedHBV”amisnomer—stillHBVDNAinliver

5、cccDNAWerle-LapostolleB,etal.Gastroenterology.2004;126:1750-1758.HBV能被清除吗?Immunecontrol—notclearance“ResolvedHBV”amisnomer—stillHBVDNAinliverTcellTcellTcellcccDNAWerle-LapostolleB,etal.Gastroenterology.2004;126:1750-1758.免疫抑制的后果ImmunecontrolcanbelostImmune-media

6、tedliverdamagewithimmunereconstitutionHIVSteroidsChemotxTcellTcellTcellcccDNAWerle-LapostolleB,etal.Gastroenterology.2004;126:1750-1758.免疫抑制的后果ImmunecontrolcanbelostImmune-mediatedliverdamagewithimmunereconstitutionHIVSteroidsChemotxTcellTcellTcellcccDNAWerle-La

7、postolleB,etal.Gastroenterology.2004;126:1750-1758.HBV再激活5-30YrsMos-YrsInfectionImmunotoleranceImmuneClearanceHBeAg+HBeAg-HBeAb+Mos-YrsALTHBVDNAHBeAg+HoofnagleJH.Hepatology.2009;49(5suppl):S156-S165.HBV再激活5-30YrsMos-YrsInfectionImmunotoleranceImmuneClearanceHBeA

8、g+HBeAg-HBeAb+Mos-YrsALTHBVDNAHBeAg+ImmuneSuppressionHoofnagleJH.Hepatology.2009;49(5suppl):S156-S165.HBV再激活InfectionImmunotoleranceImmuneClearanceHBeAg+HBeAg-HBeAb+A