_______________ « » . 20 __ . 116-1114 : « » : ., ., ., ., . ., ., . , 2014 ( - ) , , , , , , . , , . , , . : . : . : HBV , 350-400 (HBsAg). HBV : , B, ). HBV, , 5-10% “ ”, 1 . ( HBeAgHBeAg- ) HBeAg- . , , HBV. , ( , REVEAL). 5 8% , 20%. 5 20%. HBV14-35%. . , 2 , HBs , . B , , . HBV , , , . HBV (cccDNA). , HBV. HBV , , , . , , . HBsAg, , , . , . . : ; ; ; . , , . , , ( ), , . . , , 1 3 . , , ( 3 ) . 3 2 . HBeAg HBeAg- , HBeAg -HBe. HBsAg HBsAg -HBs. . ( ( )/ ): . HBV 2000 , . 6 12 HBV 6 . 2000 12 . (- HBV ( ): 1 log10 3 . HBV . , 3-6 . . , HBV ( – 1 log10 . – , 6 ) HBV , 1 log10 ; – 4 . , (, . . , , , ( HBV , 12 , 2000 ). : ( 2 HAI Ishak) . , , , . 3 , 5 348 , , , , 51% 1 , 71 96 (74%) . : HBsAg. . HBeAg, HBeAg. : HBV, , . , HBV , 2000 : ; ; (A2-A3), (F2 METAVIR). . HBV>20000 , 2 5 , . , HBV<20000 , >2000 , , , 40 , . , . HBeAg ( 3 2000 ) ., , 20000 , . 3 3 HBV . 6-12 . 3 , HBV. . HBeAg 2 . HBeAg HBV 20000 . ( ). HBV . HBV . . . HBeAg1) 2) HBeAg: HBV; , , , . . ( ), , 6 . , , - , . , , , 2-3 . ( ) : L- ( , ( ); ). , – - , ), . . . HBeAg- . 6 12- 12 1. 1. HBeAg12- 6 12 (- -2a 180 -HBe,% HBV<60-80 ,% ,b 100 600 245 32 16-18 22 21 14 36-44 60 76 41 41-72 77 68 3 0-1 0,5 3 % HBsAg, % 1 , (- 1 . b ( <1,25 ( ) <1,3 ). 7 HBeAg- . 6 12- 12 2. 2. HBeAg12- 6 12 (- -2a 180 HBV<60-80 ,% ,b % HBsAg, % 100 600 245 19 72-73 88 93 59 71-79 74 76 4 0 0 0 1 , (- 1 . b ( <1,25 ( ) <1,3 ). , -HBe HBV HBV C , D. (APASL) , 5 , . . , : HBeAg- HBeAg 6 6 12 HBe- anti-HBe 12 . HBV – 2000 . – HBV : 12 HBsAg. HBe- , 8 HBsAg , HBsAg HBV . HBV HBsAg anti-HBs. 3 . HBsAg 6 HBeAg- , <20000 HBV HBe 12 , - 50%; HBV . -HBe , HBsAg 1500 12 -HBe HBsAg HBeAg -HBe , 20000 -HBe . 24 . <20000 HBV 12 HBeAg50% . HBsAg <2 log10 HBV HBeAg- HBV D. ( ), . 48HBeAg- , -HBe . 1 , . 12 12 , . HBeAg24 . ) 12 , 4 12 HBV HBsAg HBeAg , HBeAg 24 HBV 9 anti-HBe anti-HBe ( 12 HBeAg. APASL 3 , 3 . HBeAg- HBsAg 6-12 HBV. . , . , . , . : 3 HBeAgHBsAg<20000 HBsAg, HBe. . HBeAg- , D, 3 HBsAg HBV<2 log10 ME/ , . . . . , : ( HBV) 24 48 . HBeAgHBeAg HBsAg HBsAg. . HBV , . , ) HBV, . 10 . HBV, , , , HBV, 6 , (<2x108 HBeAg- <2x106 HBV HBeAg6 . ), . . HBeHBV < 2000 HBsAg. – HBeAg anti-HBe HBV . 6 . 3-6 , -HBe . -HBe , , , . HBV( ). HBV, . HBeAg 12 ( ); -HBe ) 40-80% , HBsAg 12 , . HBsAg . HBe- . , 11 . , HBeAg- , -HBe . HBeAg -HBe . 10-15 ( ) HBV HBV, . 3 , , – 3-6 . , . , . , , HBV . , , . : . , – . . . . . , ( 24 ), ( , 48 . ) HBV. HBV , . 12 , , HBV . , . , HBV , . , , . , , , , . , , , . . . . ( , ). ( ). . . . , . , . HBV , . 3 HBV . HBV 13 . . , . . 12HBe- , HBeHBs- HBsAg , – HBeAgHBsAg HBs- . . HBV . . . , . MELD , , HBV HBV- . . HBsAgHBVHBV. (HBIg) 10%. , HBIg . , , , , . . , HBV 14 , . HBV . , . : , . CD4>500/ HBV- . , . , 12 HBV, . HBV HDV. HDV , , HDV , D) D ( . HDV, 70-90% HDVHDV anti- HDV IgM. HDV 4 – HDV3-6 1 2,8% , . . HDV. , , . 25-40% HDV , HBsAg. HDV , , . HDV , 15 , HBV HBV 2000 . HCV. HBV- . HCV HBV HBV , . , HCV . . HCV- HCVHBV- . HCV- HBV HCV. HBV: . . 95-99% HBVanti-HBs . . , . HBV- . , 3 12 HBs- HBe- HBsAg. . HBV 9% (>7-8 log10 39% ). . FDA – , . , . (Antiretroviral Pregnancy Registry) , . 16 . , , . , , . . , . . HBV- , , , HBV. , , , . , FDA ( , ). HBV, , , HBIg HBV( 10 000 000 . HBV HBe- ), 1 000 000. 10% HBIg HBV . , HBIg . , ( 30 ) ( 1 000 000-10 000 000 ). , 17 HBsHBV 3 . . . , HBV. . , 10 . , . , , . HBsAg- , , HBV- . , . HBsAg- , - , , , . anti-HBcore. HBVanti-HBs HBsAg- HBsAg . . , HBV. , , HBV, , 12 . , (<2000 ) HBV . HBV . HBV, 18 , . HBsAg- anti-HBcore HBV HBV. , HBsAg- . HBsAg- anti-HBcore anti-HBs), , HBV. HBV ( - HBV . – 1-3 . HBsAg- anti-HBcore, , anti-HBs HBV. anti-HBcore . . ( ) HBV; HBe, HBe- ; , ) ( ; ; HBV- ; ; HBsAg). 19