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乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)感染的血清学标志主要有乙肝病毒表面抗原、乙肝病毒表面抗体、乙肝病毒e抗原(Hepatitis B e Antigen,HBeAg)、乙肝病毒e抗体和乙肝病毒核心抗体。慢性HBV感染自然史复杂、多样,与初次感染年龄、HBV载量、基因型、突变位点、HBeAg状态、丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)水平、丙型肝炎病毒和/或丁型肝炎病毒合并感染及宿主免疫状态等有关。慢性HBV感染过程可分免疫耐受期、免疫清除期、低或无病毒复制期和病毒恢复活性期。部分HBeAg阴性、ALT高水平和HBV脱氧核糖核酸高滴度(>105拷贝/ml)患者,可出现肝硬化、肝细胞癌和肝功能衰竭等肝脏相关综合征。现有证据表明,合理使用抗HBV药物可减少后遗症发生率和病死率。
Serological markers of Hepatitis B Virus (HBV) infection mainly include hepatitis B virus surface antigen, hepatitis B virus surface antigen, hepatitis B virus e antigen (HBeAg), hepatitis B virus e antibody and hepatitis B Virus core antibody. The natural history of chronic HBV infection is complex and diverse, and is related to age of primary infection, HBV load, genotype, mutation site, HBeAg status, Alanine Aminotransferase (ALT) level, Hepatitis C virus and / Hepatitis B virus infection and host immune status and so on. Chronic HBV infection can be divided into immune tolerance period, immune clearance, low or no virus replication and viral recovery activity. Some patients with cirrhosis, hepatocellular carcinoma and liver failure may develop liver-related syndromes in some HBeAg-negative patients, patients with high levels of ALT, and high titer of HBV DNA (> 105 copies / ml). The available evidence shows that the rational use of anti-HBV drugs can reduce the incidence of sequelae and mortality.