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1、乙型肝炎病毒再激活:一個能夠預(yù)防的問題南昌大學(xué)第一附屬醫(yī)院張倫理HBV再激活的發(fā)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能被清除嗎?Immunecontrol—notclearance“ResolvedHBV”amisnomer—stillHBVDNAinlivercccDNAWerle-LapostolleB,etal.Gastroenterology.2004;126:1750-1758.HBV能被清除嗎?Immunecontrol—notclearance“ResolvedHBV”amisnomer—stillHBVDNAinliver
5、cccDNAWerle-LapostolleB,etal.Gastroenterology.2004;126:1750-1758.HBV能被清除嗎?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I(lǐng)nfectionImmunotoleranceImmuneClearanceHBeAg+HBeAg-HBeAb+A
