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Российский журнал гастроэнтерологии, гепатологии, колопроктологии

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Перенесенный гепатит В: разрешившаяся проблема или мнимое благополучие?

https://doi.org/10.22416/1382-4376-2021-31-1-7-19

Полный текст:

Аннотация

Цель обзора: оценить клиническое значение перенесенного вирусного гепатита В (ПГВ).

Основные положения. Для ПГВ характерно сохранение ДНК вируса в организме (включая внутрипеченочную cccDNA и интегрированную ДНК). Возможное сохранение персистенции вируса в гепатоцитах пациента, перенесшего гепатит В, создает потенциальную угрозу передачи инфекта через гемотрансфузии, трансплантацию органов и гемодиализ. Скрытое течение вирусной инфекции у лиц с ПГВ может служить основой для ее реактивации на фоне иммуносупрессивной или химиотерапии. При хронических заболеваниях печени различной этиологии наличие ПГВ у пациента в анамнезе значительно повышает риск цирроза и рака печени. Имеющиеся данные об ассоциации ПГВ с аутоиммунными заболеваниями печени и внепеченочным раком органов желудочно-кишечного тракта нуждаются в тщательном изучении для подтверждения возможной роли вируса гепатита В в генезе этих заболеваний.

Заключение. Несмотря на наблюдающееся при ПГВ исчезновение клинических и лабораторных признаков острого или хронического заболевания, клиренс HBsAg и снижение до неопределяемого уровня ДНК ВГВ в крови, это не всегда означает окончательное разрешение проблемы. Идентификация ПГВ у условно здоровых лиц и пациентов с различными хроническими заболеваниями способствует более точному определению глобального прогноза, позволяет уменьшить риск передачи вируса и предотвратить реактивацию инфекции.

Об авторе

С. Н. Бацких
Московский клинический научно-практический центр имени А.С. Логинова Департамента здравоохранения города Москвы
Россия

Бацких Сергей Николаевич — кандидат медицинских наук, старший научный сотрудник отдела гепатологии МКНЦ им. А.С. Логинова



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Бацких С.Н. Перенесенный гепатит В: разрешившаяся проблема или мнимое благополучие? Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2021;31(1):7-19. https://doi.org/10.22416/1382-4376-2021-31-1-7-19

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Batskikh S.N. Resolved Hepatitis B: Achieved or Imaginary Wellbeing? Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2021;31(1):7-19. (In Russ.) https://doi.org/10.22416/1382-4376-2021-31-1-7-19

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