Hepatitis B virus persistence and reactivation

被引:123
作者
Shi, Yu [1 ,2 ,3 ]
Zheng, Ming [1 ,2 ,3 ]
机构
[1] Zhejiang Univ, State Key Lab Diag & Treatment Infect Dis, Affiliated Hosp 1, Sch Med, Hangzhou, Peoples R China
[2] Collaborat Innovat Ctr Diag & Treatment Infect Di, Hangzhou, Peoples R China
[3] Natl Clin Res Ctr Infect Dis, Hangzhou, Peoples R China
来源
BMJ-BRITISH MEDICAL JOURNAL | 2020年 / 370卷
关键词
T-CELL RESPONSES; CLOSED CIRCULAR DNA; RESOLVED HBV INFECTION; HEPATOCELLULAR-CARCINOMA; LAMIVUDINE THERAPY; ANTIVIRAL THERAPY; CANCER-PATIENTS; E-ANTIGEN; LIVER-TRANSPLANTATION; PREEMPTIVE LAMIVUDINE;
D O I
10.1136/bmj.m2200
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hepatitis B virus (HBV) infection causes chronic hepatitis and has long term complications. Individuals ever infected with HBV are at risk of viral reactivation under certain circumstances. This review summarizes studies on HBV persistence and reactivation with a focus on the definitions and mechanisms. Emphasis is placed on the interplay between HBV replication and host immunity as this interplay determines the patterns of persistence following viral acquisition. Chronic infections exhibit as overt persistence when a defective immune response fails to control the viral replication. The HBV genome persists despite an immune response in the form of covalently closed circular DNA (cccDNA) and integrated DNA, rendering an occult state of viral persistence in individuals whose infection appears to have been resolved. We have described HBV reactivation that occurs because of changes in the virus or the immune system. This review aims to raise the awareness of HBV reactivation and to understand how HBV persists, and discusses the risks of HBV reactivation in a variety of clinical settings.
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页数:16
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