B型肝炎與腎臟移植

Hepatitis B and Kidney Transplantation

10.6340/KD.2016.28(1).06

陳致中(Chih-Chung Chen)；吳明儒(Ming-Ju Wu)；徐國雄(Kuo-Hsiung Shu)；鄭志雄(Chi-Hung Cheng)；游棟閔(Tung-Min Yu)

B型肝炎 ； 腎臟移植 ； KDIGO臨床指引 ； hepatitis B ； kidney transplantation ； KDIGO guideline

腎臟與透析

28卷1期（2016 / 03 / 01）

22 - 26

繁體中文

血液透析病人感染B型肝炎的風險很高，在疫苗和嚴密隔離的策略下，這風險在西方國家已經顯著降低，但在發展中國家風險仍很高。在腎移植接受者使用免疫抑制劑會加速病毒的複製。為數不少的研究顯示HBV的感染會增加死亡的風險，大部分是因為肝病和移植腎衰竭。有效的抗病毒藥物可抑制病毒複製並延緩肝病的進展，也可能降低肝癌的風險。改善全球腎臟病預後組織(KDIGO)臨床指引針對B型肝炎的病人根據現行的證據提供了實際且重要的建議。

Patients under hemodialysis are at increased risk of acquiring HBV infection. The risk has come down considerably in Western countries following the introduction of universal immunization and strict isolation practices, but remains substantial in developing countries. Viral replication is accelerated following introduction of immunosuppression in kidney transplant recipients. A number of studies have shown that HBV infection increases the risk of mortality, most often due to liver disease and graft failure. Effective antiviral therapy permits inhibition of viral replication and retards development of progressive liver disease, and may lower the risk of liver cancer. KDIGO guideline offered practical and important suggestions to HBV infected patients according to current evidences.

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