Hepatitis B Virus

DeckerMed Medicine Pub Date : 2021-01-29 DOI:10.2310/im.5483

M. Lin, A. Wall

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Abstract

Chronic hepatitis B virus (HBV) infection is a major health burden worldwide, with approximately 257 million people with chronic infection. HBV is a small partially double-stranded DNA virus that replicates within the nucleus of the hepatocyte and commonly leads to chronic infection. Chronic HBV infection can cause cirrhosis, hepatocellular carcinoma, and extrahepatic manifestations such as glomerulonephritis or vasculitis. The latter is due to deposition of circulating immune complex in the different tissues. The natural history of HBV infection can be conceptualized as a spectrum encompassing different phases, including immune tolerance, immune clearance, inactive carrier, and reactivation and resolution. The diagnosis of the different phases of chronic HBV infection relies on various HBV serologies, liver enzyme levels, and histology findings. There are currently eight therapies approved for the treatment of HBV. Tenofovir alafenamide was the most recently approved therapy with a better side effect profile compared with tenofovir disoproxil fumarate. With the recent advances in the basic research in hepatitis B, new treatment options may become available in the near-future. This review contains 9 figures, 11 tables and 80 references Key words: cirrhosis, entecavir, Hepadnaviridae, hepatitis B virus, hepatocellular carcinoma, precore mutation, tenofovir

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乙型肝炎病毒

慢性乙型肝炎病毒(HBV)感染是世界范围内的一个主要健康负担，约有2.57亿人患有慢性感染。HBV是一种小的部分双链DNA病毒，在肝细胞细胞核内复制，通常导致慢性感染。慢性HBV感染可引起肝硬化、肝细胞癌和肝外表现，如肾小球肾炎或血管炎。后者是由于循环免疫复合物在不同组织中的沉积。HBV感染的自然历史可以被定义为一个包含不同阶段的谱，包括免疫耐受、免疫清除、无活性载体、再激活和消退。慢性HBV感染不同阶段的诊断依赖于不同的HBV血清学、肝酶水平和组织学结果。目前有8种疗法被批准用于治疗HBV。与富马酸替诺福韦二氧吡酯相比，替诺福韦阿拉那胺是最近批准的副作用更小的治疗方法。随着乙型肝炎基础研究的最新进展，新的治疗方案可能在不久的将来出现。关键词:肝硬化，恩替卡韦，肝炎病毒科，乙肝病毒，肝细胞癌，突变前，替诺福韦

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DeckerMed Medicine

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