HBV-инфекция у пациентов после трансплантации печени (Обзор литературы)

Хроническое инфицирование вирусом гепатита B (НBV-инфекция) широко распространено во всем мире. Согласно данным Всемирной организации здравоохранения, около 300 млн человек в мире имеют маркеры HBV-инфекции, распространенность варьирует от 0,4 до 8,5% в зависимости от региона. НBV-инфекция без лечения, по крайней мере, у одной трети пациентов приводит к тяжелому заболеванию печени, включая цирроз печени и гепатоцеллюлярную карциному. В то время как вакцинация и новые противовирусные препараты эффективны в предотвращении тяжелых последствий HBV-инфекции, трансплантация печени остается единственным радикальным методом лечения пациентов с циррозом печени на фоне поражения печени HBV-инфекцией. У больных с репликацией HBV рецидив в трансплантате возникает в 100% случаев, что требует проведения противовирусной терапии в сочетании с иммуносупрессивной. По данным литературы, у пациентов без репликации и даже у пациентов без маркеров перенесенной HBV-инфекции НВV-инфекция de novo после ортотопической трансплантации печени наблюдается в 1,7–5% случаев [Castells L. et al., 2002]. После трансплантации печени реципиентам печени с исходным хроническим гепатитом В и пациентам с гепатитом В, возникшим de novo после трансплантации, показано проведение длительной противовирусной терапии.

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