肝细胞癌免疫治疗期间的HBV再激活:风险因素和临床管理
Yurou Jin1,2, Chao Jin3, Ronghui Xie1
1Department of Infectious Diseases, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China.
Frontiers in immunology
|February 26, 2026
概括
乙型肝炎病毒的重新激活 (HBVr) 是接受治疗的肝细胞癌 (HCC) 患者的重大风险,影响疗效和存活率. 本综述详细介绍HBVr风险,后果和管理策略,包括新疗法.
科学领域:
- 肝病学和病毒瘤学
- 免疫疗法和癌症治疗方法
背景情况:
- 乙型肝炎病毒重新激活 (HBVr) 是肝细胞癌 (HCC) 患者的关键并发症,特别是在现代免疫疗法中.
- 乙型肝炎病毒可以降低治疗效果和患者的存活率,特别是在使用免疫检查点抑制剂或氨酸激酶抑制剂时.
研究的目的:
- 综合审查HBVr在HCC患者中的病毒学,临床和免疫病理学方面.
- 检查HCC治疗期间的HBVr风险因素,临床后果和基于证据的治疗策略.
- 讨论新兴的治疗方法,以消灭HBV储存和恢复免疫监测.
主要方法:
- 对HCC中HBVr的当前证据的系统审查.
- 对病毒学基础,风险因素和免疫病理学机制的分析.
- 检查临床后果和管理方法,包括新的治疗策略.
主要成果:
- 卷积闭环DNA (cccDNA) 的持久性和治疗诱导的免疫失调是HBVr.的关键因素.
- 包括免疫疗法在内的HCC治疗增加HBVr风险,导致肝细胞损伤和更差的预后.
- 目前的管理包括查,抗病毒预防和多学科护理,新疗法正在开发中.
结论:
- 在HCC患者中有效管理HBVr需要综合方法,从预防到新疗法.
- 了解HBVr机制对于改善HCC治疗结果和生存至关重要.
- 新兴疗法对长期控制和潜在的B型肝炎病毒的根除有希望.
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