慢性HCV肝炎抗病毒疗效的预测和临床评估.pptVIP

慢性HCV肝炎抗病毒疗效的预测和临床评估 Natural History of HCV infection Exposure Self Resolution 15% Chronic Infection Liver Cirrhosis End Stage Liver Disease Liver Transplant Hepatocellular Carcinoma Death 85% Stable 80% (68%) 20% (17%) 25% (4%) Slowly Progressive 75% (13%) 20-30 yr Alcohol HIV HBV Immunosuppression Older age B cell CD8+ CTL Hepatocyte CD4+ Th cell Y Y Y Y Y NK NKT cells Immune response to HCV infection : Role largely unknown - early, vigorous, multi- specific response - strong NS3-response in resolving acute HCV - TH1 in recovery - TH2 in chronic - vigorous, multi- specific response