预防乙型肝炎病毒再激活培训课件
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Werle-Lapostolle B, et al. Gastroenterology预. 2防0乙04型;1肝26炎:1病7毒50再-1激7活58.
8
免疫抑制的后果
cccDNA
T cell T cell
HIV Steroids Chemotx
T cell
Immune control can be lost
10
HBV 再激活
HBeAg+
HBeAg-
Immunotolerance Immune Clearance
HBeAb+
HBV DNA
HBeAg+
ALT
5-30 Yrs
Mos-Yrs
Mos-Yrs
Infection
Hoofnagle JH. Hepatology. 2009;49(5 supp预l):防S1乙5型6-肝S炎16病5毒. 再激活
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
HIV Steroids Chemotx
T源自文库cell
Immune control can be lost
Immune-mediated liver damage with immune reconstitution
Werle-Lapostolle B, et al. Gastroenterology预. 2防0乙04型;1肝26炎:1病7毒50再-1激7活58.
Immune Clearance
Immune Control (Nonreplicative)
Most Oncology Patients ▪ Normal ALT ▪ Low/undetectable HBV DNA ▪ HBsAg+ and HBeAg▪ or HBsAg-, anti-HBc+
HBsAg+ ALT
5-30 Yrs
Mos-Yrs
Infection
Yim HJ, et al. Hepatology. 2006;43:S173-S预18防1乙. 型肝炎病毒再激活
HBsAg- HBsAb+
Mos-Yrs
5
HBV能被清除吗?
cccDNA
Immune control—not clearance “Resolved HBV” a misnomer—still HBV DNA in liver
Information for International Travel 2012. N预ew防Y乙o型rk肝: O炎x病fo毒rd再U激n活iversity Press; 2012.
3
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
Infection
Yim HJ, et al. Hepatology. 2006;43:S173-S预18防1乙. 型肝炎病毒再激活
HBeAg- HBeAb+ HBsAg- HBsAb+
Mos-Yrs
4
慢性乙肝病毒感染自然史
Immunotolerance HBV DNA
预防乙型肝炎病毒再激活
HBV再激活的发生
预防乙型肝炎病毒再激活
2
Hepatitis B: Some Sobering Facts
Prevalence of HBsAg
High ≥ 8% Intermediate 2% to 7% Low < 2%
350 million people chronically infected
11
HBV 再激活
HBeAg+
HBeAg- HBeAb+
Immunotolerance Immune Clearance
Immune Suppression
HBV DNA
HBeAg+
ALT
5-30 Yrs
Mos-Yrs
Mos-Yrs
Infection
Hoofnagle JH. Hepatology. 2009;49(5 supp预l):防S1乙5型6-肝S炎16病5毒. 再激活
Immune-mediated liver damage with immune
reconstitution
Werle-Lapostolle B, et al. Gastroenterology预. 2防0乙04型;1肝26炎:1病7毒50再-1激7活58.
9
免疫抑制的后果
cccDNA
T cell T cell
Werle-Lapostolle B, et al. Gastroenterology预. 2防0乙04型;1肝26炎:1病7毒50再-1激7活58.
6
HBV能被清除吗?
cccDNA
Immune control—not clearance “Resolved HBV” a misnomer—still HBV DNA in liver
12
HBV 再激活
HBeAg+
HBeAg- HBeAb+
Immunotolerance Immune Clearance
Immune Suppression
HBeAg+ Immune Reconstitution
HBV DNA
ALT
5-30 Yrs
Mos-Yrs
Mos-Yrs
Infection
Hoofnagle JH. Hepatology. 2009;49(5 supp预l):防S1乙5型6-肝S炎16病5毒. 再激活
Werle-Lapostolle B, et al. Gastroenterology预. 2防0乙04型;1肝26炎:1病7毒50再-1激7活58.
7
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