特集名 | 肝疾患の予後 | |
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題名 | B型肝炎キャリアの自然経過と予後 | |
発刊年月 | 1997年 10月 | |
著者 | 飯野 四郎 | 聖マリアンナ医科大学内科学・臨床検査医学 |
【 要旨 】 | B型肝炎ウイルス(HBV)キャリアの自然経過はHBe抗原陽性期からB型慢性肝炎期を経てHBe抗体陽性期に至る.HBe抗体陽性期では大部分の例は無症候性キャリアであり,予後は良好である.しかし,一部の例では慢性活動性肝炎,肝硬変,肝細胞癌などがみられることから,肝病変の精密な評価と定期的なcheckが必要である. 近年,HBV遺伝子の研究からHBe抗原からHBe抗体への移行過程にみられる遺伝子変異やB型慢性肝炎でみられる病態と遺伝子変異の関係が明らかになりつつある.しかし,ウイルス学的に,また,臨床観察の点から,HBVキャリアの自然経過に関して不明な,未解決な問題が多く残されており,その点を指摘した. |
Theme | Prognosis of Liver Diseases | |
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Title | Natural History and Prognosis in Chronic Hepatitis B Virus Infection | |
Author | Shiro Iino | Department of Medicine and Laboratory Medicine, St. Marianna University, School of Medicine |
[ Summary ] | The natural course of carriers of hepatitis B virus (HBV) is a progression from the initial HBeAg-positive phase to a chronic hepatitis B phase and then to an anti-HBe antibody-positive phase. The majority of patients in the anti-HBe antibody-positive phase are asymptomatic carriers and the prognosis for these patients is good. However, since chronic active hepatitis, liver cirrhosis, and hepatocellular carcinoma occur in some patients, periodic close evaluation of the liver disease is regularly necessary. The gene mutation is observed in the HBeAg to anti-HBe transition process and the relationship between the disease features observed in chronic hepatitis B and gene mutation are being clarified by advances in recent HBV genome research. Virologically and from the clinical perspective, however, many aspects of the natural course of HBV carriers remain unknown or unresolved, and these facets of the carrier state are emphasized herein. |