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【摘要】：免疫抑制治疗期间HBV再激活的情况并不少见，这与肝炎爆发及肝功能失代偿引起的显著的发病率和死亡率有关，必须引起重视。然而，这种潜在并发症的预防和管理仍是临床医师工作中的难点。回顾了HBV再激活的诊断标准和临床结果，讨论了免疫抑制治疗如何影响HBV再激活的风险，并概述了预防HBV再激活的策略及最新进展。认为在免疫抑制治疗前对HBV感染者的早期识别至关重要，根据其风险分层，适时的启动抗病毒治疗可有效降低HBV再激活风险。希望借此提高临床医生对HBV再激活的认识，为优化HBV感染的管理和预防提供有效的参考。
【Abstract】：HBV reactivation is commonly seen during immunosuppressive therapy and is associated with high incidence and mortality rates due to hepatitis outbreak and liver decompensation, and therefore, it should be taken seriously. However, the prevention and management of this potential complication is still a difficulty in clinical practice. This article reviews the diagnostic criteria and clinical outcomes of HBV reactivation, discusses the association of immunosuppressive therapy with the risk of HBV reactivation, and outlines the strategies for the prevention of HBV reactivation and recent advances. It is pointed out that early identification of patients with HBV infection before immunosuppressive therapy is of vital importance, and the initiation of antiviral therapy at the right moment based on risk stratification can effectively reduce the risk of HBV reactivation. We hope that this review can increase the awareness of HBV reactivation among clinicians and provide an effective reference for optimizing the management and prevention of HBV infection.
【关键字】：肝炎病毒, 乙型； 病毒激活； 免疫抑制剂； 综述
【Key words】：hepatitis B virus； virus activation； immunosuppressive agents; review
【引证本文】：DONG KH, FANG YN, KUI YW, et al. Management and prevention of HBV reactivation in the context of immunosuppression［J］. J Clin Hepatol, 2018, 34(10): 2213-2216. （in Chinese)
董凯惠， 方伊娜， 蒉乙文， 等. 免疫抑制背景下HBV再激活的管理和预防［J］. 临床肝胆病杂志, 2018, 34(10): 2213-2216.