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乙型肝炎病毒通过免疫抑制重新激活:隐藏的威胁?

Sama Anvari^1,2, Keith Tsoi^1,2

¹Division of Gastroenterology, Department of Internal Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada.

Journal of clinical medicine

|January 23, 2024

概括

乙型肝炎病毒 (HBV) 再激活的风险随着免疫抑制治疗而变化. 建议HBsAg+患者进行抗病毒预防,而HBsAg-患者需要个性化评估.

科学领域:

肝病学肝病学是一种肝病学.
免疫学免疫学免疫学
药理学药理学是指药理学的学科.

背景情况:

乙型肝炎病毒 (HBV) 再激活是免疫抑制疗法期间的重大风险.
乙型肝炎病毒重新激活的风险概况根据使用的特定免疫抑制剂而异.
了解这些风险对于预防治疗患者的肝损伤至关重要.

研究的目的:

审查各种免疫抑制剂相关的HBV再激活风险的文献.
为临床医生提供一种管理算法,用于管理患有HBV再激活风险的患者.
根据HBV血清状况 (HBsAg+与HBsAg-),突出显示风险的变化.

主要方法:

使用谷歌学者,PubMed和MEDLINE进行全面的文献搜索.
专注于研究乙型肝炎的重新激活和免疫抑制剂.
综合发现以评估风险分层和管理策略.

主要成果:

乙型肝炎病毒的重新激活风险取决于病原体,并且在慢性乙型肝炎病毒 (HBsAg+) 和过去的乙型肝炎病毒 (HBsAg-,抗HBc+) 感染之间有所不同.
抗CD20药物和造血干细胞移植具有最高的重新激活风险 (>10%).
社会指南建议对HBsAg+患者进行抗病毒预防,但对HBsAg-患者的建议不太一致.

结论:

临床医生必须在开始免疫抑制治疗之前评估HBV状态.
对于HBsAg+患者,一般建议进行抗病毒预防.
患有HBsAg的患者需要对预防进行个别评估,需要对最佳治疗持续时间进行进一步的研究.

关键词:

肝炎肝炎是什么意思肝炎肝炎是什么意思乙型肝炎病毒的感染.免疫抑制是一种免疫抑制.再激活重新激活的方法

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