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| 1 | 化疗相关乙肝病毒再激活的诊治现状显示文摘全球近1/3的人口感染过乙肝,多数分布在许多亚洲国家中。我国是乙肝大国,我国现有的慢性乙肝病毒感染者约9 300万人。化学治疗是肿瘤综合治疗中的一项重要手段,随着人口寿命增加和癌症发病率逐年增长,癌症患者接受化疗治疗后,乙肝病毒再激活已经成为癌症化疗中不可忽视的问题。再激活可能导致严重肝损害,迫使患者推迟化疗甚至死于肝衰竭。化疗病人乙肝病毒再激活能够被核苷(酸)类药物有效地预防,但预防及治疗的最佳策略仍在研究中。 | 孙德聪 陈丽 吴志勇 戴广海 | 2014 | 中国临床药理学与治疗学2014，19，5： | 11 |
| 2 | Management of hepatitis B reactivation in immunosuppressed patients: An update on current recommendations显示文摘The proportion of hepatitis B virus(HBV) previously exposed patients who receive immunosuppressive treatment is usually very small. However, if these individuals are exposed to potent immunosuppressive compounds, the risk of HBV reactivation(HBVr) increases with the presence of hepatitis B surface antigen(HBsAg) in the serum. Chronic HBsAg carriers have a higher risk than those who have a total IgG anticore as the only marker of resolved/occult HBV disease. The loss of immune control in these patients may results in the reactivation of HBV replication within hepatocytes. Upon reconstitution of the immune system, infected hepatocytes are once again targeted and damaged by immune surveillance in an effort to clear the virus. There are different virological scenarios, and a wide spectrum of associated drugs with specific and stratified risk for the development of HBVr. Some of this agents can trigger a severe degree of hepatocellular damage, including hepatitis, acute liver failure, and even death despite employment of effective antiviral therapies. Currently, HBVr incidence seems to be increasing around the world; a fact mainly related to the incessant appearance of more powerful immunosuppressive drugs launched to the market. Moreover, there is no consensus on the length of prophylactic treatment before the patients are treated with immunosuppressive therapy, and for how long this therapy should be extended once treatment is completed. Therefore, this review article will focus on when to treat, when to monitor, what patients should receive HBV therapy, and what drugs should be selected for each scenario. Lastly, we will update the definition, risk factors, screening, and treatment recommendations based on both current and different HBV management guidelines. | Fernando Bessone Melisa Dirchwolf | 2016 | World Journal of Hepatology2016，8，8： | 10 |
| 3 | 应用免疫抑制剂或化疗药物的慢性乙肝患者HBV再激活及其治疗显示文摘乙型肝炎病毒(HBV)感染呈全球分布,全世界约20亿人曾感染HBV,慢性HBV感染者约3.5亿。中国是HBV高流行区,慢性HBV携带者约1.2亿,占全世界的1/3。在这部分人群中,部分患者因合并其他疾病而需运用免疫抑制剂或化疗药物,由于其免疫功能状态的改变,可能导致HBV再激活,从而引起肝功能受损甚至发生暴发性肝衰竭而威胁生命。 | 黄燕 范学工 | 2012 | 临床内科杂志2012，29，8： | 5 |
| 4 | Hepatitis B surface antigen seroconversion after HBV reactivation in non-Hodgkin's lymphoma显示文摘Reactivation of hepatitis B virus(HBV)can occur in lymphoma patients infected with HBV when they receive chemotherapy or immunotherapy.Prophylactic administration of lamivudine(LAM)reduces the morbidity and mortality associated with HBV reactivation.However,what defines HBV reactivation and the optimal duration of treatment with LAM have not yet been clearly established.HBV reactivation may occur due to the cessation of prophylactic LAM,although re-treatment with nucleoside analogs may sometimes result in hepatitis B surface antigen(HBsAg)seroconversion,which is a satisfactory endpoint for the management of HBV infection.We report a case of HBV reactivation in a 68-year-old HBsAg-positive patient who received rituximab-based immunochemotherapy for follicular lymphoma.HBV reactivation developed following cessation of prophylactic LAM therapy.The patient subsequently received treatment with entecavir(ETV),which led to a rapid and sustained suppression of HBV replication and HBsAg seroconversion.We also appraised the literature concerning HBV reactivation and the role of ETV in the management of HBV reactivation in lymphoma patients.A total of 28 cases of HBV reactivation have been reported as having been treated with ETV during or after immunosuppressive chemotherapy in lymphoma patients.We conclude that ETV is an efficacious and safe treatment for HBV reactivation following LAM cessation in lymphoma patients treated with rituximab-based immunochemotherapy. | Wei-Ping Liu Wen Zheng Yu-Qin Song Ling-Yan Ping Gui-Qiang Wang Jun Zhu | 2014 | World Journal of Gastroenterology2014，20，17： | 4 |
| 5 | 恩替卡韦联合胸腺肽α1治疗慢性乙型肝炎疗效研究显示文摘目的:观察和比较恩替卡韦联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎的疗效。方法:选取我院58例HBeAg阳性慢性乙型肝炎患者分成联合组和对照组。联合组28例,初始同时使用恩替卡韦及胸腺肽α124周,之后停胸腺肽α1继续用恩替卡韦至48周。对照组30例,单用恩替卡韦0.5mg/d,48周。定期检测ALT复常率,HBVDNA转阴率,HBeAg/抗HBe血清转换率,肝纤维化组合,Fibroscan评分两组在治疗结束时进行疗效评价。结果:24周时两组ALT复常率无差异显著性(P>0.05),联合组和对照组HBV DNA阴转率在24周、48周时均差异有显著性(P<0.05)。联合组与单用组HBeAg血清转换率在第24周、48周时,两组比较差异均有显著性(P<0.05)。肝纤维化组合各指标(HA,LN,PⅢP,Ⅳ型胶原),Fibroscan评分两组治疗48周后比较差异均有显著性(P<0.05),且两组治疗前后差异联合组更显著。治疗过程中,未发现明显副作用。结论:恩替卡韦联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎,安全性与耐受性良好,联合组在ALT复常率,HBeAg血清转换率和HBV DNA转阴率,抗肝纤维化的疗效上显著优于单用恩替卡韦组。 | 宁鹏 徐珞 | 2011 | 现代生物医学进展2011，11，10： | 4 |
| 6 | Hepatitis B virus infection reactivation in patients under immunosuppressive therapies:Pathogenesis,screening,prevention and treatment显示文摘With a 5.3%of the global population involved,hepatitis B virus(HBV)is a major public health challenge requiring an urgent response.After a possible acute phase,the natural history of HBV infection can progress in chronicity.Patients with overt or occult HBV infection can undergo HBV reactivation(HBVr)in course of immunosuppressive treatments that,apart from oncological and hematological diseases,are also used in rheumatologic,gastrointestinal,neurological and dermatological settings,as well as to treat severe acute respiratory syndrome coronavirus 2 infection.The risk of HBV reactivation is related to the immune status of the patient and the baseline HBV infection condition.The aim of the present paper is to investigate the risk of HBVr in those not oncological settings in order to suggest strategies for preventing and treating this occurrence.The main studies about HBVr for patients with occult hepatitis B infection and chronic HBV infection affected by non-oncologic diseases eligible for immunosuppressive treatment have been analyzed.The occurrence of this challenging event can be reduced screening the population eligible for immunosuppressant to assess the best strategies according to any virological status.Further prospective studies are needed to increase data on the risk of HBVr related to newer immunomodulant agents employed in non-oncological setting. | Anna Maria Spera | 2022 | World Journal of Virology2022，11，5： | 1 |
| 7 | 透析 接受化疗 长期服用免疫抑制剂及毒瘾者抗乙型肝炎病毒治疗探讨显示文摘目前对于透析、接受化疗及长期服用免疫抑制剂和毒瘾者合并乙型肝炎病毒(HBV)感染时,其抗病毒治疗均推荐选择强效、低耐药的核苷(酸)类似物治疗,不推荐干扰素治疗。对于透析者,当转氨酶和HBV-DNA水平未达到抗病毒治疗指征时,应考虑透析因素的影响,需积极行肝活检,以明确是否需要抗病毒治疗;对于化疗或者使用免疫抑制剂者,治疗前、治疗中、治疗后均需要密切监测乙型肝炎标志物,以确定是否需HBV治疗;对于毒瘾者,选择抗病毒治疗时机时应排除药物性肝损害的可能性。 | 宋术鹏 兰英华 李用国 | 2014 | 中国实用内科杂志2014，34，6： | 0 |
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