肝移植后HBV感染(综述)

A. Nikogosova, D. Umrik, O. Tsirulnikova
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引用次数: 0

摘要

慢性乙型肝炎病毒(HBV)感染在世界各地都很常见。根据世界卫生组织(World Health Organization)的数据,全世界约有3亿人携带HBV感染标记物,根据地区的不同,患病率从0.4%到8.5%不等。未经治疗的HBV感染导致至少三分之一的患者出现严重肝病,包括肝硬化和肝细胞癌(HCC)。虽然疫苗接种和新的抗病毒药物在预防HBV感染的严重后果方面是有效的,但肝移植仍然是肝硬化HBV患者的最终治疗方法。在HBV复制的患者中,100%的病例在移植物中复发,这需要抗病毒治疗联合免疫抑制治疗。据文献报道,原位肝移植(orthotopic liver transplantation, OLTx)后无复制甚至乙型肝炎表面抗原阴性患者的乙肝病毒重新感染(de novo HBV infection)在1.7% - 5%之间[Castells L. et al., 2002]。OLTx后,基线慢性HBV感染的肝受体和移植后新发HBV感染的患者需要长期抗病毒治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Post-liver transplant HBV infection (Review)
Chronic hepatitis B virus (HBV) infection is common throughout the world. According to the World Health Organization, about 300 million people around the world are living with the HBV infection markers, with prevalence ranging from 0.4% to 8.5%, depending on the region. Untreated HBV infection results in severe liver disease, including cirrhosis and hepatocellular carcinoma (HCC), in at least one third of patients. While vaccination and new antiviral drugs are effective in preventing the severe consequences of HBV infection, liver transplantation remains the ultimate therapy for patients with HBV in cirrhosis. In patients with HBV replication, recurrence in the graft occurs in 100% of cases, which requires antiviral therapy combined with immunosuppressive therapy. According to the literature, de novo HBV infection after orthotopic liver transplantation (OLTx) in patients without replication and even in patients negative for hepatitis B surface antigen is between 1.7% and 5% [Castells L. et al., 2002]. After OLTx, liver recipients with baseline chronic HBV infection and patients with de novo HBV infection occurring after transplantation are indicated for long-term antiviral therapy.
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