医学
乙型肝炎病毒
肝细胞癌
乙型肝炎表面抗原
病毒学
免疫学
肝硬化
接种疫苗
血清学
人口
HBeAg
病毒
乙型肝炎
抗体
内科学
环境卫生
作者
C. Trépo,Henry Lik‐Yuen Chan,Anna S. Lok
出处
期刊:The Lancet
[Elsevier]
日期:2014-06-18
卷期号:384 (9959): 2053-2063
被引量:1391
标识
DOI:10.1016/s0140-6736(14)60220-8
摘要
Summary
Hepatitis B virus infection is a major public health problem worldwide; roughly 30% of the world's population show serological evidence of current or past infection. Hepatitis B virus is a partly double-stranded DNA virus with several serological markers: HBsAg and anti-HBs, HBeAg and anti-HBe, and anti-HBc IgM and IgG. It is transmitted through contact with infected blood and semen. A safe and effective vaccine has been available since 1981, and, although variable, the implementation of universal vaccination in infants has resulted in a sharp decline in prevalence. Hepatitis B virus is not cytopathic; both liver damage and viral control—and therefore clinical outcome—depend on the complex interplay between virus replication and host immune response. Overall, as much as 40% of men and 15% of women with perinatally acquired hepatitis B virus infection will die of liver cirrhosis or hepatocellular carcinoma. In addition to decreasing hepatic inflammation, long-term antiviral treatment can reverse cirrhosis and reduce hepatocellular carcinoma. Development of new therapies that can improve HBsAg clearance and virological cure is warranted.
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