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成年人症状性乙型肝炎病毒感染中约10%的患者成为病毒携带者,临床表现为慢活肝,最后进展为肝硬化、慢性迁延性肝炎或无症状的病毒携带状态.后两者偶可清除HBsAg,产生抗-HBs,而发展成慢活肝甚至肝硬变者一般被认为HBsAg永远阳性.作者观察到5例乙型慢活肝和2例由HBV引起肝硬化的患者,经2～14年携带状态后血清中HBsAg被清除,其中4例出现抗-HBs.临床资料:男性3例,女性4例,平均年龄36岁.所有患者均有程度不等的转氨酶增高(90～3000~?/ml),血清HBsAg阳性,均经肝脏活检病理证实.其中5例患者(慢活肝4例,肝硬化1例),在1～30个月不等的时间内投用常规剂量的免疫抑制剂强的松龙,有的还合用硫唑嘌呤,但至少在HBsAg被清除前3年停药.患者
Approximately 10% of adults with symptomatic hepatitis B virus infection become carriers of the virus and present clinically as slow-lived and eventually advanced cirrhosis, chronic persistent hepatitis or asymptomatic virus-carrying status. Clear HBsAg, anti-HBs, and the development of slow-living or even cirrhosis of the liver is generally considered HBsAg positive forever.The authors observed 5 cases of slow-B slow liver and liver cirrhosis caused by HBV in patients with 2 ~ Serum HBsAg was cleared after 14 years of delivery, of which 4 cases were anti-HBs. Clinical data: 3 males and 4 females with an average age of 36 years.All patients had varying degrees of transaminase (90 ~ 3000 ~ ml / ml), and positive serum HBsAg, all confirmed by biopsy of the liver.Among these 5 patients (4 with slow-survival liver and 1 with cirrhosis), they were immunized with conventional dose within the range of 1-30 months Inhibitors of prednisolone, and some also combined azathioprine, but at least three weeks before HBsAg was removed.