预防乙型肝炎病毒再激活课件
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HBsAg- HBsAb+
Mos-Yrs
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV能被清除吗?
cccDNA
Immune control—not clearance “Resolved HBV” a misnomer—still HBV DNA in liver
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV能被清除吗?
cccDNA
Immune control—not clearance “Resolved HBV” a misnomer—still HBV DNA in liver
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
免疫抑制的后果
cccDNA
T cell T cell
HIV Steroids Chemotx
350 million people chronically infected 2 billion with evidence of past or present infection Country of origin is THE major risk factor
World Health Organization. Hepatitis B Fact Sheet. Centers for Disease Control and Prevention. CDC Health Information for International Travel 2012. New York: Oxford University Press; 2012.
HBeAb+
HBV DNA
HBeAg+
ALT
5-30 Yrs
Mos-Yrs
Inபைடு நூலகம்ection
Hoofnagle JH. Hepatology. 2009;49(5 suppl):S156-S165.
Mos-Yrs
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV 再激活
T cell
Immune control can be lost
Immune-mediated liver damage with immune reconstitution
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
免疫抑制的后果
cccDNA
T cell T cell
HIV Steroids Chemotx
T cell
Immune control can be lost Immune-mediated liver damage with immune reconstitution
HBeAg+
HBeAg- HBeAb+
Immunotolerance Immune Clearance
Immune Suppression
HBV DNA
HBeAg+
ALT
5-30 Yrs
Mos-Yrs
Infection
Yim HJ, et al. Hepatology. 2006;43:S173-S181.
HBeAg- HBeAb+ HBsAg- HBsAb+
Mos-Yrs
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
慢性乙肝病毒感染自然史
Immunotolerance HBV DNA
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV 再激活
HBeAg+
HBeAg-
Immunotolerance Immune Clearance
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV再激活的发生
Hepatitis B: Some Sobering 文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。 Facts
Prevalence of HBsAg High ≥ 8% Intermediate 2% to 7% Low < 2%
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV能被清除吗?
T cell
cccDNA
T cell T cell
Immune control—not clearance “Resolved HBV” a misnomer—still HBV DNA in liver
Immune Clearance
HBsAg+ ALT
5-30 Yrs
Mos-Yrs
Infection
Yim HJ, et al. Hepatology. 2006;43:S173-S181.
Immune Control (Nonreplicative)
Most Oncology Patients ▪ Normal ALT ▪ Low/undetectable HBV DNA ▪ HBsAg+ and HBeAg▪ or HBsAg-, anti-HBc+
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
慢性乙肝病毒感染自然史
Immunotolerance HBV DNA
Immune Clearance
Immune Control (Nonreplicative)
HBeAg+ HBsAg+
ALT
5-30 Yrs
Mos-Yrs
Mos-Yrs
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV能被清除吗?
cccDNA
Immune control—not clearance “Resolved HBV” a misnomer—still HBV DNA in liver
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV能被清除吗?
cccDNA
Immune control—not clearance “Resolved HBV” a misnomer—still HBV DNA in liver
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
免疫抑制的后果
cccDNA
T cell T cell
HIV Steroids Chemotx
350 million people chronically infected 2 billion with evidence of past or present infection Country of origin is THE major risk factor
World Health Organization. Hepatitis B Fact Sheet. Centers for Disease Control and Prevention. CDC Health Information for International Travel 2012. New York: Oxford University Press; 2012.
HBeAb+
HBV DNA
HBeAg+
ALT
5-30 Yrs
Mos-Yrs
Inபைடு நூலகம்ection
Hoofnagle JH. Hepatology. 2009;49(5 suppl):S156-S165.
Mos-Yrs
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV 再激活
T cell
Immune control can be lost
Immune-mediated liver damage with immune reconstitution
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
免疫抑制的后果
cccDNA
T cell T cell
HIV Steroids Chemotx
T cell
Immune control can be lost Immune-mediated liver damage with immune reconstitution
HBeAg+
HBeAg- HBeAb+
Immunotolerance Immune Clearance
Immune Suppression
HBV DNA
HBeAg+
ALT
5-30 Yrs
Mos-Yrs
Infection
Yim HJ, et al. Hepatology. 2006;43:S173-S181.
HBeAg- HBeAb+ HBsAg- HBsAb+
Mos-Yrs
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
慢性乙肝病毒感染自然史
Immunotolerance HBV DNA
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV 再激活
HBeAg+
HBeAg-
Immunotolerance Immune Clearance
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV再激活的发生
Hepatitis B: Some Sobering 文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。 Facts
Prevalence of HBsAg High ≥ 8% Intermediate 2% to 7% Low < 2%
Werle-Lapostolle B, et al. Gastroenterology. 2004;126:1750-1758.
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
HBV能被清除吗?
T cell
cccDNA
T cell T cell
Immune control—not clearance “Resolved HBV” a misnomer—still HBV DNA in liver
Immune Clearance
HBsAg+ ALT
5-30 Yrs
Mos-Yrs
Infection
Yim HJ, et al. Hepatology. 2006;43:S173-S181.
Immune Control (Nonreplicative)
Most Oncology Patients ▪ Normal ALT ▪ Low/undetectable HBV DNA ▪ HBsAg+ and HBeAg▪ or HBsAg-, anti-HBc+
文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。
慢性乙肝病毒感染自然史
Immunotolerance HBV DNA
Immune Clearance
Immune Control (Nonreplicative)
HBeAg+ HBsAg+
ALT
5-30 Yrs
Mos-Yrs