非酒精性脂肪性肝病对乙型肝炎病毒感染影响的研究进展

doi:10.3969/j.issn.1674-8115.2023.12.015

摘要/Abstract

摘要：

慢性乙型肝炎（chronic hepatitis B，CHB）是由乙型肝炎病毒（hepatitis B virus，HBV）持续感染所致的一种传染性疾病，在世界范围内有较高的流行率。非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）是除酒精和其他肝损伤因素以外，一组与代谢异常相关的肝脏疾病。近年来，随着人们生活水平的提高和生活方式的改变，NAFLD发病率逐年升高，已成为中国以及西方国家最常见的肝脏疾病，同时也是西方国家肝移植的第二大原因。NAFLD患病率的升高导致了慢性HBV感染合并NAFLD的发病率也随之升高。但目前国内外对此2种疾病之间的关系，包括NAFLD对HBV感染者疾病演变、发病机制，以及抗病毒疗效的影响及预后争议较多，且目前国内外指南均未对其诊疗方案进行详细描述。该文归纳总结了近年来HBV感染合并NAFLD的相关研究进展，包括HBV感染合并NAFLD的流行病学、诊断标准，HBV感染合并NAFLD对乙型肝炎病毒学的影响，NAFLD对HBV负性抑制的可能机制，HBV感染合并NAFLD对抗病毒治疗效果的影响以及HBV感染者合并NAFLD的预后，以期进一步深入认识疾病本身，并为基础研究、临床研究及诊疗方案提供新思路。

关键词: 乙型肝炎病毒, 慢性乙型肝炎, 非酒精性脂肪性肝病, 抗病毒治疗, 肝癌

Abstract:

Chronic hepatitis B (CHB) is an infectious disease caused by persistent infection with the hepatitis B virus (HBV) and is highly prevalent worldwide. Non-alcoholic fatty liver disease (NAFLD) is a group of liver diseases related to metabolic abnormalities, excluding those caused by alcohol consumption or other liver injury factors. In recent years, with improvement of living standards and changes in lifestyle, the incidence of NAFLD has been increasing substantially, becoming the most common type of liver diseases in China and Western countries, and the second leading cause of liver transplantation in the West. The rising prevalence of NAFLD has also led to an increase in the incidence of NAFLD in patients with chronic HBV infection. However, there is considerable controversy both domestically and internationally regarding the relationship between these two diseases, including the disease progression, pathogenesis, impact on antiviral treatment efficacy, and prognosis of these concomitant CHB and NAFLD patients. Currently, both domestic and international guidelines lack detailed descriptions of diagnostic and treatment strategies for these conditions. This article summarizes the recent research progress in concomitant CHB and NAFLD, including epidemiology, diagnostic criteria, the impact of NAFLD on the virology of HBV infection, potential mechanisms of NAFLD-induced negative regulation of HBV, the effect of NAFLD on antiviral therapy efficacy, and prognosis. This article aims to gain a deeper understanding of the diseases themselves and provide new insights for basic and clinical research as well as diagnostic and treatment approaches.

Key words: hepatitis B virus (HBV), chronic hepatitis B (CHB), non-alcoholic fatty liver disease (NAFLD), antiviral therapy, hepatocellular carcinoma

中图分类号:

R575.5

BENEDICK Jun Er Chin, SON Peng, 张亦凡, 王俊青, 郭斯敏. 非酒精性脂肪性肝病对乙型肝炎病毒感染影响的研究进展[J]. 上海交通大学学报（医学版）, 2023, 43(12): 1585-1590.

BENEDICK Jun Er Chin, SON Peng, ZHANG Yifan, WANG Junqing, GUO Simin. Research progress of the impact of nonalcoholic fatty liver disease on chronic hepatitis B infection[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(12): 1585-1590.

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