慢性乙型肝炎的免疫耐受性尚未解决的问题

StephenW

Unresolved issues of immune tolerance in chronic hepatitis B

    Hye Won Lee & Henry Lik-Yuen Chan

Journal of Gastroenterology volume 55, pages383–389(2020)Cite this article

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Abstract

During the natural course of chronic hepatitis B virus infection, immune-tolerant phase is characterized by high viral replication, the presence of HBV e antigen (HBeAg), and normal or minimally elevated serum alanine aminotransferase. Immune-tolerant phase is usually regarded as a benign course of the disease. International guidelines recommend observation rather than treatment during immune-tolerant phase. In this article, we review unresolved issues related to the definition of true immune-tolerant phase and the benefit of antiviral treatment. Defining true immune-tolerant phase requires a careful approach and long-term follow-up. In previous studies, many patients were misclassified as being immune-tolerant phase. Noninvasive methods of assessing fibrosis are warranted for patients in the immune-tolerant phase. Yet, there has been controversy over the benefit and harm of antiviral treatment for immune-tolerant phase patients. Thus, further larger scale studies are needed to investigate the prognosis of patients in true immune-tolerant phase and their need for antiviral therapy.

StephenW

慢性乙型肝炎的免疫耐受性尚未解决的问题

李慧媛＆陈力源

胃肠病学杂志第55卷，第383--389页（2020年）引用本文

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抽象

在慢性乙型肝炎病毒感染的自然过程中，免疫耐受阶段的特征是病毒复制高，HBV e抗原（HBeAg）的存在以及血清丙氨酸氨基转移酶的正常或最低水平升高。免疫耐受期通常被认为是该病的良性病程。国际指南建议在免疫耐受阶段观察而不是治疗。在本文中，我们回顾了与真正的免疫耐受期的定义和抗病毒治疗的益处有关的未解决的问题。定义真正的免疫耐受期需要谨慎的方法和长期的随访。在先前的研究中，许多患者被误分类为免疫耐受期。对于处于免疫耐受期的患者，必须采用非侵入性的方法来评估纤维化。然而，对于免疫耐受期患者抗病毒治疗的益处和危害一直存在争议。因此，需要进一步的大规模研究来研究处于真正的免疫耐受期的患者的预后以及他们对抗病毒治疗的需求。

StephenW

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