The Efficacy of of Antiviral Therapy on the Regression of Liver Fibrosis in CHB

34 Pages·2017·2.84 MB·English

The Efficacy of of Antiviral Therapy
on the Regression of Liver Fibrosis in CHB
Jidong Jia, MD, PhD
首都医科大学附属北京友谊医院
Beijing Friendship Hospital, Capital Medical University 1
Global annual mortality from hepatitis, HIV, tuberculosis and malaria
2000–2015:
Source: Global Health Estimates 2015: deaths by cause, age, sex, by country and by region, 2000-2015. Geneva: WHO; 2016.)
Deaths from viral hepatitis, by virus and type of sequelae in
2015
Source: Global Health Estimates 2015: deaths by cause, age, sex, by country and by region, 2000-2015. Geneva: WHO; 2016.)
3.3%
3.5%
2.0%
1.6%
6.2%
0.7%
6.1%
WHO: GLOBAL HEPATITIS REPORT, 2017
Age-standardised disability-adjusted life-year rates
attributable to HBV in 2013, by country
Per 100 000 per year
DALY=伤残调整寿命年
Stanaway JD, et al. Lancet 2016 5
Etiology of the 8080 liver cirrhosis patients
in southern China
n (%)
Others 944 ( 0.12 ) …….. ………
Wang X, et al. World J Gastroenterol 2014
Natural history of chronic HBV infection
Acute HBV infection
95% infants1 5%-10% Adults1
Chronic HBV infection
Chronic Hepatitis
HBeAg(+)：8%-17% in 5y 2
HBeAg (-)：13%-38% in 5y 2
Cirrhosis
3%-6% per y 1 ≈20% in 5y 2
Decompensation
HCC
1. Chinese guidelines of chronic hepatitis B (2010). Chin Hepatol 20171;5:13-24
2. Vallet-Pichard A,et al. Expert Rev Anti Infect Ther. 2009 ;7:527-35.
HBV level is the major driver
for disease progression
HBV promotes expression of TGF by Kupffer
n
o
i
s
s
e
r
p N=6,P=0.001 N=6,P=0.001
x
e
HBV

e
6 Log
v
i
t
a
le HBV
对照
r 4 Log
1

F
G
T
9
Li H, et al. Dig Liver Dis. 2012.44:328-33.
HBV-C, X proteins promote mRNA levels
of PDGF/-R in HSCs (LX-2)
10
Bai QX, et al. Int J Mol Med. 2012;30: 1443-50