臨牀消化器内科 Vol.31 No.3(1-2)


特集名 B型肝炎―根絶に向けて
題名 B型肝炎の疫学と病態 (2) HBVキャリアの自然経過と肝発癌
発刊年月 2016年 03月
著者 八橋 弘 国立病院機構長崎医療センター臨床研究センター
【 要旨 】 HBs抗原陽性が6カ月間以上持続陽性の者をHBVキャリアと呼ぶ.HBVキャリアは,ALT値,組織所見,HBVウイルスマーカー(HBV‒DNA,HBeAg,HBsAg)によって,(1) Immune tolerance期,(2) Immune clearance期(HBeAg+chronic hepatitis B期),(3) Low replicative期(Inactive carrier state期),(4) Reactivation期(HBeAg-chronic hepatitis B期),(5) Recovery期という五つの時相に分類する.HBVキャリアのなかから肝硬変,肝癌に進展する例があり,そのリスク因子をよく理解する必要がある.
Theme Hepatitis B : Towards the Elimination
Title Natural Course and Hepatocellular Carcinoma Development of HBV Carrier
Author Hiroshi Yatsuhashi Clinical Research Center, NHO Nagasaki Medical Center
[ Summary ] An HBV carrier is defined as an HBs antigen‒positive person who has remained positive for more than 6 months. HBV carriers are categorized into five phases according to their alanine aminotransferase (ALT) levels, histology, and HBV markers (HBV‒DNA, HB envelopeantigen [HBeAg], HBsAg) as follows, 1) Immune tolerance period, 2) Immune clearance period, (HBeAg+ chronic hepatitis B), 3) Low replicative period (inactive carrier state phase), 4) Reactivation period (HBeAg-chronic hepatitis B), and 5) Recovery period. Given that some HBV carriers will develop liver cirrhosis and liver cancer, a better understanding of the risk factors associated with HBV infection is required.
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