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慢性HBV感染重叠非酒精性脂肪性肝病临床与基础研究的现状及展望

蒋丽娜 李玮 赵景民

蒋丽娜, 李玮, 赵景民. 慢性HBV感染重叠非酒精性脂肪性肝病临床与基础研究的现状及展望[J]. 临床肝胆病杂志, 2021, 37(7): 1489-1494. DOI: 10.3969/j.issn.1001-5256.2021.07.001
引用本文: 蒋丽娜, 李玮, 赵景民. 慢性HBV感染重叠非酒精性脂肪性肝病临床与基础研究的现状及展望[J]. 临床肝胆病杂志, 2021, 37(7): 1489-1494. DOI: 10.3969/j.issn.1001-5256.2021.07.001
JIANG L, LI W, ZHAO JM. Current status and perspectives of the clinical and basic research on concomitant chronic hepatitis B virus infection and nonalcoholic fatty liver disease [J]. J Clin Hepatol, 2021, 37(7): 1489-1494. DOI: 10.3969/j.issn.1001-5256.2021.07.001
Citation: JIANG L, LI W, ZHAO JM. Current status and perspectives of the clinical and basic research on concomitant chronic hepatitis B virus infection and nonalcoholic fatty liver disease [J]. J Clin Hepatol, 2021, 37(7): 1489-1494. DOI: 10.3969/j.issn.1001-5256.2021.07.001

慢性HBV感染重叠非酒精性脂肪性肝病临床与基础研究的现状及展望

DOI: 10.3969/j.issn.1001-5256.2021.07.001
详细信息
    通讯作者:

    赵景民,jmzhao302@163.com

  • 中图分类号: R512.62;R575.5

Current status and perspectives of the clinical and basic research on concomitant chronic hepatitis B virus infection and nonalcoholic fatty liver disease

  • 摘要: 慢性乙型肝炎病毒感染(CBI)与非酒精性脂肪性肝病(NAFLD)是世界范围内慢性肝病常见的两大病因,CBI重叠或合并NAFLD(Co-CBI&NAFLD)的情况较普遍。Co-CBI&NAFLD两者的相互影响作用,尤其是NAFLD对慢性乙型肝炎(CHB)疾病进展、抗病毒疗效及结局的影响作用尚存在争议。现有的Co-CBI&NAFLD临床与基础研究结果显示,NAFLD能够一定程度上抑制HBV DNA复制,表现为血清HBV DNA载量相对较低,并可能增加慢性CHB患者血清HBsAg转阴率;基于临床前瞻性或回顾性队列研究显示,Co-CBI&NAFLD较单纯CHB肝纤维化进展呈加快趋势,乃至肝硬化及HCC发生率亦呈增加态势;Co-CBI/NAFLD组织学上两者病变并存,各自特征性病变鉴别困难。目前Co-CBI&NAFLD的自然史、发病机制尚不清楚,其病理学特征尚待确认,NAFLD对CHB疾病进程的影响作用,尤其是对抗病毒疗效的影响及疾病结局尚缺乏高等级的循证医学证据,国内外尚无Co-CBI&NAFLD诊疗或管理指南。对上述问题的解决,无疑将有助于加深对Co-CBI&NAFLD的理解与认识,规范并提高临床诊疗或管理效果,降低相关终末期肝病的发生率和病死率。

     

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