Chronic Hepatitis B with Spontaneous Severe Acute Exacerbation

International Journal of Molecular Sciences

Wei-Lun Tsai¹  Wei-Chi Sun¹  Jin-Shiung Cheng¹ 

[1]Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan

关键词: hepatitis B;    acute exacerbation;    antiviral treatment;   

DOI  :  10.3390/ijms161226087

来源: mdpi

【 摘 要 】

Chronic hepatitis B virus (HBV) infection is a major global health problem with an estimated 400 million HBV carriers worldwide. In the natural history of chronic hepatitis B (CHB), spontaneous acute exacerbation (AE) is not uncommon, with a cumulative incidence of 10%–30% every year. While exacerbations can be mild, some patients may develop hepatic decompensation and even die. The underlying pathogenesis is possibly related to the activation of cytotoxic T lymphocyte-mediated immune response against HBV. An upsurge of serum HBV DNA usually precedes the rise of alanine aminotransferase (ALT) and bilirubin. Whether antiviral treatment can benefit CHB with severe AE remains controversial, but early nucleos(t)ide analogues treatment seemed to be associated with an improved outcome. There has been no randomized study that compared the effects of different nucleos(t)ide analogues (NA) in the setting of CHB with severe AE. However, potent NAs with good resistance profiles are recommended. In this review, we summarized current knowledge regarding the natural history, pathogenetic mechanisms, and therapeutic options of CHB with severe AE.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.