Инфекция, вызванная вирусом гепатита В (ВГВ), представляет собой глобальную проблему общественного здравоохранения. Спектр клинических проявлений ВГВ-инфекции варьирует как при остром, так и при хроническом течении заболевания. Во время острой фазы проявления варьируют от субклинического гепатита до безжелтушного гепатита, желтушного гепатита и фульминантного (молниеносного) гепатита; во время хронической фазы проявления варьируют от бессимптомного носительства до хронического гепатита, цирроза печени и гепатоцеллюлярной карциномы. Клинический исход ВГВ-инфекции зависит от возраста инфицирования, уровня репликации ВГВ и иммунного статуса хозяина.

easloffice@easloffice.eu, European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection // J Hepatol 2017; 67:370.

Feld JJ, Terrault NA, Lin HS, et al. Entecavir and Peginterferon Alfa-2a in Adults With Hepatitis B e Antigen-Positive Immune-Tolerant Chronic Hepatitis B Virus Infection // Hepatology 2019; 69:2338.

Fontana RJ, Hann HW, Perrillo RP, et al. Determinants of early mortality in patients with decompensated chronic hepatitis B treated with antiviral therapy // Gastroenterology 2002; 123:719.

GBD 2017 Cirrhosis Collaborators. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 // Lancet Gastroenterol Hepatol 2020; 5:245.

Harpaz R, Von Seidlein L, Averhoff FM, et al. Transmission of hepatitis B virus to multiple patients from a surgeon without evidence of inadequate infection control // N Engl J Med 1996; 334:549.

Huang JM, Huang TH, Qiu HY, et al. Effects of hepatitis B virus infection on human sperm chromosomes // World J Gastroenterol 2003; 9:736.

Hui CK, Leung N, Yuen ST, et al. Natural history and disease progression in Chinese chronic hepatitis B patients in immune-tolerant phase // Hepatology 2007; 46:395.

Kumar M, Sarin SK, Hissar S, et al. Virologic and histologic features of chronic hepatitis B virus-infected asymptomatic patients with persistently normal ALT // Gastroenterology 2008; 134:1376.

Kumar M, Satapathy S, Monga R, et al. A randomized controlled trial of lamivudine to treat acute hepatitis B // Hepatology 2007; 45:97.

Kwon H, Lok AS. Hepatitis B therapy // Nat Rev Gastroenterol Hepatol 2011; 8:275.

Lai M, Hyatt BJ, Nasser I, et al. The clinical significance of persistently normal ALT in chronic hepatitis B infection // J Hepatol 2007; 47:760.

Lee HA, Lee HW, Kim IH, et al. Extremely low risk of hepatocellular carcinoma development in patients with chronic hepatitis B in immune-tolerant phase // Aliment Pharmacol Ther 2020; 52:196.

Lin CL, Kao JH, Chen BF, et al. Application of hepatitis B virus genotyping and phylogenetic analysis in intrafamilial transmission of hepatitis B virus // Clin Infect Dis 2005; 41:1576.

Mast EE, Margolis HS, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents // MMWR Recomm Rep 2005; 54:1.

Mast EE, Weinbaum CM, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults // MMWR Recomm Rep 2006; 55:1.

Maynard JE. Hepatitis B: global importance and need for control // Vaccine 1990; 8 Suppl:S18.

Nelson PK, Mathers BM, Cowie B, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews // Lancet 2011; 378:571.

Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity // Vaccine 2012; 30:2212.

Rosenthal P, Ling SC, Belle SH, et al. Combination of Entecavir/Peginterferon Alfa-2a in Children With Hepatitis B e Antigen-Positive Immune Tolerant Chronic Hepatitis B Virus Infection // Hepatology 2019; 69:2326.

Sarin SK, Kumar M, Lau GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update // Hepatol Int 2016; 10:1.

Sinn DH, Lee J, Goo J, et al. Hepatocellular carcinoma risk in chronic hepatitis B virus-infected compensated cirrhosis patients with low viral load // Hepatology 2015; 62:694.

Stramer SL, Notari EP, Krysztof DE, Dodd RY. Hepatitis B virus testing by minipool nucleic acid testing: does it improve blood safety? // Transfusion 2013; 53:2449.

Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance // Hepatology 2018; 67:1560.

Theodoropoulos N, Jaramillo A, Ladner DP, Ison MG. Deceased organ donor screening for HIV, hepatitis B, and hepatitis C viruses: a survey of organ procurement organization practices // Am J Transplant 2013; 13:2186.

Thompson ND, Perz JF, Moorman AC, Holmberg SD. Nonhospital health care-associated hepatitis B and C virus transmission: United States, 1998-2008 // Ann Intern Med 2009; 150:33.

Weinbaum CM, Williams I, Mast EE, et al. Recommendations for identification and public health management of persons with chronic hepatitis B virus infection // MMWR Recomm Rep 2008; 57:1.

Williams IT, Perz JF, Bell BP. Viral hepatitis transmission in ambulatory health care settings // Clin Infect Dis 2004; 38:1592.

Wong GL, Wong VW, Choi PC, et al. Evaluation of alanine transaminase and hepatitis B virus DNA to predict liver cirrhosis in hepatitis B e antigen-negative chronic hepatitis B using transient elastography // Am J Gastroenterol 2008; 103:3071.

Yao FY, Terrault NA, Freise C, et al. Lamivudine treatment is beneficial in patients with severely decompensated cirrhosis and actively replicating hepatitis B infection awaiting liver transplantation: a comparative study using a matched, untreated cohort // Hepatology 2001; 34:411.

Yapali S, Talaat N, Lok AS. Management of hepatitis B: our practice and how it relates to the guidelines // Clin Gastroenterol Hepatol 2014; 12:16.

Yuan P, Chen P, Qian Y. Evaluation of Antiviral Therapy Performed after Curative Therapy in Patients with HBV-Related Hepatocellular Carcinoma: An Updated Meta-Analysis // Can J Gastroenterol Hepatol 2016; 2016:5234969.

Белопольская М.А., Воронина О.И.. Беременность и вирусный гепатит // Вестник Российского университета дружбы народов. Серия: Медицина, no. 5, 2012, pp. 465-475.

Ежлова Е.Б. и соавт. Вакцинопрофилактика вирусного гепатита // Инфекция и иммунитет, vol. 2, no. 1-2, 2012, pp. 440-440.

Кузнецов Н.И. Вирусный гепатит // Российский семейный врач, vol. 16, no. 4, 2012, pp. 13-18.

Содержание Вирус гепатита В Патогенез гепатита В Эпидемиология гепатита В Пути передачи вирусного гепатита В Острый гепатит В Хронический гепатит В Фазы хронического гепатита В Лечение гепатита В Продолжительность и конечные точки лечения ВГВ Тактика при неудачном лечении ВГВ Профилактика ВГВ Список литературы Инфекция, вызванная вирусом гепатита В (ВГВ), представляет собой глобальную проблему общественного здравоохранения. Спектр клинических проявлений ВГВ-инфекции варьирует как при остром, так и при хроническом течении заболевания. Во время острой фазы проявления варьируют от субклинического гепатита до безжелтушного гепатита, желтушного гепатита и фульминантного (молниеносного) гепатита; во время хронической фазы проявления варьируют от бессимптомного носительства до хронического гепатита, цирроза печени и гепатоцеллюлярной карциномы. Клинический исход ВГВ-инфекции зависит от возраста инфицирования, уровня репликации ВГВ и иммунного статуса хозяина. easloffice@easloffice.eu, European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection // J Hepatol 2017; 67:370. Feld JJ, Terrault NA, Lin HS, et al. Entecavir and Peginterferon Alfa-2a in Adults With Hepatitis B e Antigen-Positive Immune-Tolerant Chronic Hepatitis B Virus Infection // Hepatology 2019; 69:2338. Fontana RJ, Hann HW, Perrillo RP, et al. Determinants of early mortality in patients with decompensated chronic hepatitis B treated with antiviral therapy // Gastroenterology 2002; 123:719. GBD 2017 Cirrhosis Collaborators. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 // Lancet Gastroenterol Hepatol 2020; 5:245. Harpaz R, Von Seidlein L, Averhoff FM, et al. Transmission of hepatitis B virus to multiple patients from a surgeon without evidence of inadequate infection control // N Engl J Med 1996; 334:549. Huang JM, Huang TH, Qiu HY, et al. Effects of hepatitis B virus infection on human sperm chromosomes // World J Gastroenterol 2003; 9:736. Hui CK, Leung N, Yuen ST, et al. Natural history and disease progression in Chinese chronic hepatitis B patients in immune-tolerant phase // Hepatology 2007; 46:395. Kumar M, Sarin SK, Hissar S, et al. Virologic and histologic features of chronic hepatitis B virus-infected asymptomatic patients with persistently normal ALT // Gastroenterology 2008; 134:1376. Kumar M, Satapathy S, Monga R, et al. A randomized controlled trial of lamivudine to treat acute hepatitis B // Hepatology 2007; 45:97. Kwon H, Lok AS. Hepatitis B therapy // Nat Rev Gastroenterol Hepatol 2011; 8:275. Lai M, Hyatt BJ, Nasser I, et al. The clinical significance of persistently normal ALT in chronic hepatitis B infection // J Hepatol 2007; 47:760. Lee HA, Lee HW, Kim IH, et al. Extremely low risk of hepatocellular carcinoma development in patients with chronic hepatitis B in immune-tolerant phase // Aliment Pharmacol Ther 2020; 52:196. Lin CL, Kao JH, Chen BF, et al. Application of hepatitis B virus genotyping and phylogenetic analysis in intrafamilial transmission of hepatitis B virus // Clin Infect Dis 2005; 41:1576. Mast EE, Margolis HS, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents // MMWR Recomm Rep 2005; 54:1. Mast EE, Weinbaum CM, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults // MMWR Recomm Rep 2006; 55:1. Maynard JE. Hepatitis B: global importance and need for control // Vaccine 1990; 8 Suppl:S18. Nelson PK, Mathers BM, Cowie B, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews // Lancet 2011; 378:571. Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity // Vaccine 2012; 30:2212. Rosenthal P, Ling SC, Belle SH, et al. Combination of Entecavir/Peginterferon Alfa-2a in Children With Hepatitis B e Antigen-Positive Immune Tolerant Chronic Hepatitis B Virus Infection // Hepatology 2019; 69:2326. Sarin SK, Kumar M, Lau GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update // Hepatol Int 2016; 10:1. Sinn DH, Lee J, Goo J, et al. Hepatocellular carcinoma risk in chronic hepatitis B virus-infected compensated cirrhosis patients with low viral load // Hepatology 2015; 62:694. Stramer SL, Notari EP, Krysztof DE, Dodd RY. Hepatitis B virus testing by minipool nucleic acid testing: does it improve blood safety? // Transfusion 2013; 53:2449. Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance // Hepatology 2018; 67:1560. Theodoropoulos N, Jaramillo A, Ladner DP, Ison MG. Deceased organ donor screening for HIV, hepatitis B, and hepatitis C viruses: a survey of organ procurement organization practices // Am J Transplant 2013; 13:2186. Thompson ND, Perz JF, Moorman AC, Holmberg SD. Nonhospital health care-associated hepatitis B and C virus transmission: United States, 1998-2008 // Ann Intern Med 2009; 150:33. Weinbaum CM, Williams I, Mast EE, et al. Recommendations for identification and public health management of persons with chronic hepatitis B virus infection // MMWR Recomm Rep 2008; 57:1. Williams IT, Perz JF, Bell BP. Viral hepatitis transmission in ambulatory health care settings // Clin Infect Dis 2004; 38:1592. Wong GL, Wong VW, Choi PC, et al. Evaluation of alanine transaminase and hepatitis B virus DNA to predict liver cirrhosis in hepatitis B e antigen-negative chronic hepatitis B using transient elastography // Am J Gastroenterol 2008; 103:3071. Yao FY, Terrault NA, Freise C, et al. Lamivudine treatment is beneficial in patients with severely decompensated cirrhosis and actively replicating hepatitis B infection awaiting liver transplantation: a comparative study using a matched, untreated cohort // Hepatology 2001; 34:411. Yapali S, Talaat N, Lok AS. Management of hepatitis B: our practice and how it relates to the guidelines // Clin Gastroenterol Hepatol 2014; 12:16. Yuan P, Chen P, Qian Y. Evaluation of Antiviral Therapy Performed after Curative Therapy in Patients with HBV-Related Hepatocellular Carcinoma: An Updated Meta-Analysis // Can J Gastroenterol Hepatol 2016; 2016:5234969. Белопольская М.А., Воронина О.И Беременность и вирусный гепатит // Вестник Российского университета дружбы народов. Серия: Медицина, no. 5, 2012, pp. 465-475. Ежлова Е.Б. и соавт. Вакцинопрофилактика вирусного гепатита // Инфекция и иммунитет, vol. 2, no. 1-2, 2012, pp. 440-440. Кузнецов Н.И. Вирусный гепатит // Российский семейный врач, vol. 16, no. 4, 2012, pp. 13-18.

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