抗病毒治疗对肝纤维化逆转的影响

罗昕; 曲颖; 蔡晓波; 陆伦根

doi:10.3969/j.issn.1001-5256.2022.11.032

抗病毒治疗对肝纤维化逆转的影响

DOI: 10.3969/j.issn.1001-5256.2022.11.032

上海交通大学医学院附属第一人民医院消化科，上海 200080

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：罗昕负责综述资料分析，撰写论文；曲颖、蔡晓波负责审阅修改论文；陆伦根负责综述选题，指导撰写文章并最后定稿。

详细信息

通信作者:
陆伦根，lungenlu1965@163.com

计量
- 文章访问数: 1022
- HTML全文浏览量: 518
- PDF下载量: 118
- 被引次数: 0
出版历程
- 收稿日期: 2022-04-07
- 录用日期: 2022-07-06
- 出版日期: 2022-11-20

Effects of antiviral therapy on the reversal of liver fibrosis

Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China

More Information

Corresponding author: LU Lungen, lungenlu1965@163.com(ORCID: 0000-0002-1533-4068)

摘要

摘要: 肝纤维化是各种慢性肝病进展的必经阶段，最终会演化至肝硬化甚至肝癌。病毒性肝炎是导致肝纤维化的最主要原因，抗病毒治疗对病毒性肝炎的血清学转化及肝纤维化的逆转有着重要作用。本文总结归纳了抗病毒治疗对肝纤维化病理学逆转的作用、相关的分子机制以及目前仍存在的局限，以期为后续的相关临床与基础研究提供一定的参考。
- 肝硬化 /
- 抗病毒药 /
- 病理过程
Abstract: As an inevitable stage in the progression of various chronic liver diseases, liver fibrosis eventually develops into liver cirrhosis or cancer. Because viral infection is a major cause of liver fibrosis, antiviral therapy is critical in the seroconversion and reversal of liver fibrosis in viral hepatitis. This review summarizes the clinical effects and underlying molecular mechanisms of antiviral therapy in the pathological reversal of liver fibrosis, as well as the current limitations, with the goal of providing literature references for upcoming clinical and basic research.
- Liver Cirrhosis /
- Antiviral Agents /
- Pathologic Processes

HTML全文

参考文献(23)

[1]	GINÈS P, KRAG A, ABRALDES JG, et al. Liver cirrhosis[J]. Lancet, 2021, 398(10308): 1359-1376. DOI: 10.1016/S0140-6736(21)01374-X.
[2]	CHEN XF, ZHANG DJ, LUO XD, et al. Current status of the treatment of chronic hepatitis B[J]. J Clin Hepatol, 2021, 37(5): 1011-1015. DOI: 10.3969/j.issn.1001-5256.2021.05.004. 陈学福, 张东敬, 罗晓丹, 等. 慢性乙型肝炎的治疗现状[J]. 临床肝胆病杂志, 2021, 37(5): 1011-1015. DOI: 10.3969/j.issn.1001-5256.2021.05.004.
[3]	CAO W, CHEN HD, YU YW, et al. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020[J]. Chin Med J (Engl), 2021, 134(7): 783-791. DOI: 10.1097/CM9.0000000000001474.
[4]	PAROLA M, PINZANI M. Liver fibrosis: Pathophysiology, pathogenetic targets and clinical issues[J]. Mol Aspects Med, 2019, 65: 37-55. DOI: 10.1016/j.mam.2018.09.002.
[5]	EVERHART JE, WRIGHT EC, GOODMAN ZD, et al. Prognostic value of Ishak fibrosis stage: findings from the hepatitis C antiviral long-term treatment against cirrhosis trial[J]. Hepatology, 2010, 51(2): 585-594. DOI: 10.1002/hep.23315.
[6]	BEDOSSA P, POYNARD T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group[J]. Hepatology, 1996, 24(2): 289-293. DOI: 10.1002/hep.510240201.
[7]	HO SY, WANG LC, HSU CY, et al. Metavir fibrosis stage in hepatitis C-Related hepatocellular carcinoma and association with noninvasive liver reserve models[J]. J Gastrointest Surg, 2020, 24(8): 1860-1862. DOI: 10.1007/s11605-020-04627-1.
[8]	CAMPANA L, IREDALE JP. Regression of liver fibrosis[J]. Semin Liver Dis, 2017, 37(1): 1-10. DOI: 10.1055/s-0036-1597816.
[9]	ZHANG BY, CHAI DP, WU YH, et al. Potential drug targets against hepatitis B virus based on both virus and host factors[J]. Curr Drug Targets, 2019, 20(16): 1636-1651. DOI: 10.2174/1389450120666190729115646.
[10]	MARCELLIN P, GANE E, BUTI M, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study[J]. Lancet, 2013, 381(9865): 468-475. DOI: 10.1016/S0140-6736(12)61425-1.
[11]	SUN Y, ZHOU J, WANG L, et al. New classification of liver biopsy assessment for fibrosis in chronic hepatitis B patients before and after treatment[J]. Hepatology, 2017, 65(5): 1438-1450. DOI: 10.1002/hep.29009.
[12]	JIANG XY, HUANG B, HUANG DP, et al. Long-term follow-up of cumulative incidence of hepatocellular carcinoma in hepatitis B virus patients without antiviral therapy[J]. World J Gastroenterol, 2021, 27(11): 1101-1116. DOI: 10.3748/wjg.v27.i11.1101.
[13]	CHEN S, ZHOU J, WU X, et al. Comparison of fibrosis regression of entecavir alone or combined with pegylated interferon alpha2a in patients with chronic hepatitis B[J]. Hepatol Int, 2021, 15(3): 611-620. DOI: 10.1007/s12072-021-10162-1.
[14]	POYNARD T, MCHUTCHISON J, MANNS M, et al. Impact of pegylated interferon alfa-2b and ribavirin on liver fibrosis in patients with chronic hepatitis C[J]. Gastroenterology, 2002, 122(5): 1303-1313. DOI: 10.1053/gast.2002.33023.
[15]	KANDA T, GOTO T, HIROTSU Y, et al. Molecular mechanisms driving progression of liver cirrhosis towards hepatocellular carcinoma in chronic hepatitis B and C infections: A review[J]. Int J Mol Sci, 2019, 20(6): 1358. DOI: 10.3390/ijms20061358.
[16]	LUEDDE T, KAPLOWITZ N, SCHWABE RF. Cell death and cell death responses in liver disease: mechanisms and clinical relevance[J]. Gastroenterology, 2014, 147(4): 765-783. e4. DOI: 10.1053/j.gastro.2014.07.018.
[17]	ROEHLEN N, CROUCHET E, BAUMERT TF. Liver fibrosis: Mechanistic concepts and therapeutic perspectives[J]. Cells, 2020, 9(4): 875. DOI: 10.3390/cells9040875.
[18]	PAQUISSI FC. Immunity and fibrogenesis: The role of Th17/IL-17 axis in HBV and HCV-induced chronic hepatitis and progression to cirrhosis[J]. Front Immunol, 2017, 8: 1195. DOI: 10.3389/fimmu.2017.01195.
[19]	FU Y, WU S, HU Y, et al. Mutational characterization of HBV reverse transcriptase gene and the genotype-phenotype correlation of antiviral resistance among Chinese chronic hepatitis B patients[J]. Emerg Microbes Infect, 2020, 9(1): 2381-2393. DOI: 10.1080/22221751.2020.1835446.
[20]	LI HJ, HE JS, HU SL, et al. The clinical efficacy of acoustic radiation force pulse imaging, transient elastography, aspartate aminotransferase and platelet ratio index in detecting the degree of liver fibrosis in patients with hepatitis B[J]. Clin J Med Offic, 2020, 48(9): 1090-1091, 1094. DOI: 10.16680/j.1671-3826.2020.09.35. 栗红江, 何久胜, 胡素玲, 等. 声辐射力脉冲成像技术、瞬时弹性成像技术及天冬氨酸氨基转移酶与血小板比率指数联合检测乙型肝炎肝纤维化程度临床效能[J]. 临床军医杂志, 2020, 48(9): 1090-1091, 1094. DOI: 10.16680/j.1671-3826.2020.09.35.
[21]	JI D, CHEN Y, SHANG Q, et al. Unreliable estimation of fibrosis regression during treatment by liver stiffness measurement in patients with chronic hepatitis B[J]. Am J Gastroenterol, 2021, 116(8): 1676-1685. DOI: 10.14309/ajg.0000000000001239.
[22]	SUN Y, WU X, ZHOU J, et al. Persistent low level of hepatitis B virus promotes fibrosis progression during therapy[J]. Clin Gastroenterol Hepatol, 2020, 18(11): 2582-2591. e6. DOI: 10.1016/j.cgh.2020.03.001.
[23]	SARRAZIN C. Treatment failure with DAA therapy: Importance of resistance[J]. J Hepatol, 2021, 74(6): 1472-1482. DOI: 10.1016/j.jhep.2021.03.004.