丁型肝炎患者的临床管理

吴旭; 窦婧; 郭峰; 胡西百合提; 王晓忠

doi:10.12449/JCH260204

丁型肝炎患者的临床管理

DOI: 10.12449/JCH260204

1.
新疆医科大学第四临床医学院，乌鲁木齐 830099
2.
新疆医科大学附属中医医院肝病科，乌鲁木齐 830099

基金项目:

新疆维吾尔自治区“天山英才”医药卫生高层次人才培养计划 (TSYC202401B161)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：吴旭负责归纳整理文献，撰写论文；窦婧、郭峰和胡西百合提负责文献检索，资料收集；王晓忠负责提出选题，写作思路指导并最后定稿。

详细信息

通信作者:
王晓忠， wxz125@sina.com（ORCID： 0000-0002-9389-9232）

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出版历程
- 收稿日期: 2025-12-08
- 录用日期: 2026-02-24
- 出版日期: 2026-02-25

Clinical management of patients with hepatitis D

1.
The Fourth Clinical Medical College of Xinjiang Medical University，Urumqi 830099，China
2.
Department of Hepatology，Affiliated Traditional Chinese Medical Hospital of Xinjiang Medical University，Urumqi 830099，China

Research funding:

Xinjiang Uygur Autonomous Region “Tianshan Elite” High-level Medical and Health Personnel Training Program (TSYC202401B161)

More Information

Corresponding author: WANG Xiaozhong， wxz125@sina.com （ORCID： 0000-0002-9389-9232）

摘要

摘要: 丁型肝炎病毒（HDV）作为一种缺陷病毒，需依赖乙型肝炎病毒（HBV）的包膜蛋白完成复制与传播。慢性乙型肝炎患者合并HDV感染后可导致肝脏疾病进展速度显著加快，肝硬化、肝细胞癌发生风险较单纯慢性乙型肝炎患者高出数倍，给患者生命健康带来严重威胁。当前HDV筛查覆盖率有待提升，部分HBV/HDV合并感染者未被及时发现。因此，强化临床医师对HDV的认识，扩大HDV筛查范围，及早识别感染病例并给予规范抗病毒治疗及长期随访管理，对改善患者预后、减轻疾病负担、提高患者生活质量以及实现全球“2030年消除病毒性肝炎公共卫生危害”目标具有重要意义。
- 丁型肝炎 /
- 普查 /
- 诊断 /
- 治疗学 /
- 临床管理
Abstract: Hepatitis D virus （HDV）， as a defective virus， relies on the envelope protein of hepatitis B virus （HBV） to complete replication and transmission. Chronic hepatitis B （CHB） patients comorbid with HDV infection may experience significant acceleration of liver disease progression and a significantly higher risk of serious complications such as liver cirrhosis and hepatocellular carcinoma （HCC） compared with the patients with CHB alone， which poses a serious threat to the life and health of patients. At present， the coverage rate of HDV screening needs to be improved， and some patients with HBV/HDV co-infection have not been found in time. Therefore， strengthening the understanding of HDV among clinicians， expanding the scope of HDV screening， identifying patients with infection in a timely manner， and performing standardized antiviral therapy and long-term follow-up management are of great significance for improving the prognosis of patients， reducing disease burden， improving the quality of life of patients， and achieving the global goal of “eliminating viral hepatitis as a public health threat by 2030”.
- Hepatitis D /
- Mass Screening /
- Diagnosis /
- Therapeutics /
- Clinical Governance

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表 1 各指南对HDV筛查推荐情况

Table 1. Recommendations for HDV screening in various guidelines

指南	推荐意见
WHO HBV（2024）^［5］	所有HBsAg阳性者
EASL HBV（2025）^［6］	所有HBsAg阳性者（至少1次）
EASL HDV（2023）^［1］	所有HBsAg阳性者（至少1次）
CASL HBV（2025）^［7］	所有HBsAg阳性者
AASLD HBV（2018）^［8］	HBV DNA低水平且ALT升高、HDV 高危或高发地区人群
中国HBV（2022）	未提及
注：WHO，世界卫生组织；EASL，欧洲肝病学会；CASL，加拿大肝病学会；AASLD，美国肝病学会；HBV，乙型肝炎病毒；HDV，丁型肝炎病毒；HBsAg，乙型肝炎病毒表面抗原；ALT，丙氨酸氨基转移酶。

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