异基因造血干细胞移植后乙型病毒性肝炎防治新进展
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四川大学华西医院血液内科, 四川 成都 610041

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陈心传  E-mail:xinchuan_chen@163.com

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Advance in prevention and treatment of hepatitis B after allogeneic hematopoietic stem cell transplantation
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Division of Hematology, Department of Internal Medicine, West China Hospital, Sichuan University, Chengdu 610041, China

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    摘要:

    异基因造血干细胞移植(allo-HSCT)是治愈恶性血液病的有效手段,但移植患者因接受感染乙型肝炎病毒(HBV)的移植物、免疫功能严重受损等原因,术后并发乙型病毒性肝炎的风险增加。恩替卡韦和替诺福韦是目前公认用于预防allo-HSCT后乙型病毒性肝炎的有效药物,显著减少移植后患者的肝损伤。移植后患者的免疫重建时间长且重建规律存在异质性,导致术后监测和预防性抗HBV治疗的最佳持续时间尚未能明确。本文对allo-HSCT后HBV再激活的发生机制、乙型病毒性肝炎的特点及防治的最新研究进展进行综述。

    Abstract:

    Allogeneic hematopoietic stem cell transplantation(allo-HSCT) is an effective therapy to cure hematological malignancies. However, recipient's risk of developing hepatitis B after transplantation is increasing due to receiving graft infected with hepatitis B virus (HBV) and seriously impaired immune function. Entecavir and tenofovir are currently recognized as effective drugs for the prevention and treatment of hepatitis B in recipient, significantly reducing liver damage after transplantation. The immune reconstitution of recipient takes a long time and has hete-rogeneity, so the best duration of post-operative monitoring and antiviral prophylaxis is not clear. This article reviews the mechanism of hepatitis B virus reactivation, the characteristics of hepatitis B and the recent advance in prevention and treatment of hepatitis B after allo-HSCT.

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靳雪莲,董天,陈心传.异基因造血干细胞移植后乙型病毒性肝炎防治新进展[J]. 中国感染控制杂志,2021,(11):1062-1068. DOI:10.12138/j. issn.1671-9638.20217810.
Xue-lian JIN, Tian DONG, Xin-chuan CHEN. Advance in prevention and treatment of hepatitis B after allogeneic hematopoietic stem cell transplantation[J]. Chin J Infect Control, 2021,(11):1062-1068. DOI:10.12138/j. issn.1671-9638.20217810.

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  • 收稿日期:2021-06-20
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  • 在线发布日期: 2024-04-26
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