山东大学耳鼻喉眼学报 ›› 2026, Vol. 40 ›› Issue (3): 110-114.doi: 10.6040/j.issn.1673-3770.0.2025.250

• 综述 • 上一篇    下一篇

乙型肝炎病毒致聋多机制与临床预警

王梦慧,黎奥,魏浩,姜玥,吴星光,李鹿晞,钱晓云   

  1. 南京大学医学院附属鼓楼医院 耳鼻咽喉头颈外科/南京鼓楼医院耳鼻咽喉研究所, 江苏 南京 210008
  • 发布日期:2026-05-22
  • 通讯作者: 钱晓云. E-mail:qxy522@163.com
  • 基金资助:
    国家自然科学基金重大项目(82192862);国家自然科学基金面上项目(82371156、82171145);国家自然科学基金青年基金(82101223);江苏省医学重点学科/实验室(ZDXK202243)

Multiple mechanisms and clinical warning signs of deafness caused by hepatitis B virus

WANG Menghui, LI Ao, WEI Hao, JIANG Yue, WU Xingguang, LI Luxi, QIAN Xiaoyun   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Nanjing Drum Tower Hospital, Affiliated of Medical School, Nanjing University/Institute of Otorhinolaryngology, Nanjing Drum Tower Hospital, Nanjing 210008, Jiangsu, China
  • Published:2026-05-22

摘要: 乙型肝炎病毒感染是全球性的公共卫生问题,其影响不仅局限于肝脏,亦可累及其他系统,但听觉系统损伤的机制与临床特征尚未系统阐明。本研究通过循证整合发现:慢性乙型肝炎患者感音神经性听力损失发生率显著高于乙型肝炎病毒携带者,并揭示其潜在机制。同时提出突发性感音神经性聋可能是慢性乙型肝炎急性加重的预警体征。本研究为HBV感染者的听力学监测提供循证基础,建议将听力学评估纳入乙肝感染者管理路径,并推动耳保护型抗病毒药物研发。

关键词: 乙型肝炎病毒, 感音神经性听力损失, 药物耳毒性, 免疫反应

Abstract: Hepatitis B virus infection is a global public health concern. The impact of the virus is not limited to the liver, but can affect other systems too. However, the mechanisms and clinical features of auditory system damage have not been systematically clarified. Through evidence-based integration, this study found that the incidence of sensorineural hearing loss in patients with chronic hepatitis B is significantly higher than that in hepatitis B virus carriers, and potential mechanisms were revealed. Meanwhile, it is proposed that sudden sensorineural hearing loss may be a warning sign of acute exacerbation of chronic hepatitis B. This study provides an evidence-based basis for audiological monitoring of HBV-infected individuals. It is recommended that audiological assessment should be included in the management pathway for hepatitis B-infected individuals, and the development of ear-protective antiviral drugs should be promoted.

Key words: Hepatitis B virus, Sensorineural hearing loss, Drug ototoxicity, Immunoreaction

中图分类号: 

  • R512.6+2
[1] Chadha S, Kamenov K, Cieza A. The world report on hearing, 2021[J]. Bull World Health Organ, 2021, 99(4): 242-242A. doi:10.2471/blt.21.285643
[2] Gholami Parizad E, Gerami Matin H, Gholami Parizad E, et al. The prevalence of hearing loss in patients with hepatitis B infection compared with healthy volunteers[J]. Iran J Otorhinolaryngol, 2017, 29(92): 127-132
[3] Mondal K, Saha P. Study of prevalence and pattern of hearing loss in patients of hepatitis B[J]. Int J Med Biomed Stud, 2019, 3(12). doi:10.32553/ijmbs.v3i12.830
[4] Huang CC, Lin WB, Chang PH, et al. Sudden deafness as a presenting symptom of chronic hepatitis B with acute exacerbation[J]. Otolaryngol Head Neck Surg, 2009, 141(5): 659-660. doi:10.1016/j.otohns.2009.05.006
[5] 冯素兰. 病毒性肝炎并发突发性耳聋一例[J]. 北京军区医药, 1995, 7(2): 126
[6] Rzymski P, Zarębska-Michaluk D, Flisiak R. Could chronic HBV infection explain Beethoven's hearing loss? Implications for patients currently living with hepatitis B[J]. J Infect, 2023, 87(3): 171-176. doi:10.1016/j.jinf.2023.06.006
[7] Orlando MP, Masieri S, Pascarella MA, et al. Sudden hearing loss in childhood consequent to hepatitis B vaccination: a case report[J]. Ann N Y Acad Sci, 1997, 830: 319-321. doi:10.1111/j.1749-6632.1997.tb51903.x
[8] Biacabe B, Erminy M, Bonfils P. A case report of fluctuant sensorineural hearing loss after hepatitis B vaccination[J]. Auris Nasus Larynx, 1997, 24(4): 357-360. doi:10.1016/s0385-8146(97)10013-x
[9] DeJonckere PH, de Surgères GG. Acute tinnitus and permanent audiovestibular damage after hepatitis B vaccination[J]. Int Tinnitus J, 2001, 7(1): 59-61
[10] Sharifian MR, Kamandi S, Sima HR, et al. INF-α and ototoxicity[J]. BioMed Res Int, 2013, 2013: 295327. doi:10.1155/2013/295327
[11] Zittoon RF, Madian YT, Alhennawi DEM, et al. Cochlear changes caused by peginterferon α-2b[J]. J Interferon Cytokine Res, 2018, 38(7): 311-316. doi:10.1089/jir.2018.0012
[12] Thein P, Kalinec GM, Park C, et al. In vitro assessment of antiretroviral drugs demonstrates potential for ototoxicity[J]. Hear Res, 2014, 310: 27-35. doi:10.1016/j.heares.2014.01.005
[13] Sun AH, Xiao SZ, Li BS, et al. Iron deficiency and hearing loss[J]. Orl, 1987, 49(3): 118-122. doi:10.1159/000275920
[14] Ogawa K, Kanzaki J. Aplastic Anemia and sudden sensorineural hearing loss[J]. Acta Otolaryngol Suppl, 1994, 514: 85-88. doi:10.3109/00016489409127568
[15] 中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2022年版)[J]. 实用肝脏病杂志, 2023, 26(3): S18-S39. doi:10.3969/j.issn.1672-5069.2023.03.040 Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B(version 2022)[J]. Journal of Practical Hepatology, 2023, 26(3): S18-S39. doi:10.3969/j.issn.1672-5069.2023.03.040
[16] 冯变霞, 周波, 徐建虎. 基于文献计量学分析慢性乙型肝炎的研究现状[J]. 中国医药科学, 2024, 14(9): 186-190. doi:10.20116/j.issn2095-0616.2024.09.43 FENG Bianxia, ZHOU Bo, XU Jianhu. Research status of chronic hepatitis B based on bibliometrics analysis[J]. China Medicine and Pharmacy, 2024, 14(9): 186-190. doi:10.20116/j.issn2095-0616.2024.09.43
[17] Burns GS, Thompson AJ. Viral hepatitis B: clinical and epidemiological characteristics[J]. Cold Spring Harb Perspect Med, 2014, 4(12): a024935. doi:10.1101/cshperspect.a024935
[18] Yan RY, Sun MH, Yang HY, et al. 2024 latest report on hepatitis B virus epidemiology in China: current status, changing trajectory, and challenges[J]. Hepatobiliary Surg Nutr, 2025, 14(1): 66-77. doi:10.21037/hbsn-2024-754
[19] Zheng H, Wang Y, Wang FZ, et al. New progress in HBV control and the cascade of health care for people living with HBV in China: evidence from the fourth national serological survey, 2020[J]. Lancet Reg Health West Pac, 2024, 51: 101193. doi:10.1016/j.lanwpc.2024.101193
[20] McNaughton AL, D’Arienzo V, Ansari MA, et al. Insights from deep sequencing of the HBV genome-unique, tiny, and misunderstood[J]. Gastroenterology, 2019, 156(2): 384-399. doi:10.1053/j.gastro.2018.07.058
[21] Parizad EG, Khosravi A, Parizad EG, et al. Evaluation of chronic hepatitis B infection in patients with seronegative HbsAg[J]. Iran J Public Health, 2012, 41(2): 100-104
[22] Negahdari B, Darvishi M, Saeedi AA. Gold nanoparticles and hepatitis B virus[J]. Artif Cells Nanomed Biotechnol, 2019, 47(1): 455-461. doi:10.1080/21691401.2018.1553786
[23] He J, Gu DF, Wu XG, et al. Major causes of death among men and women in China[J]. N Engl J Med, 2005, 353(11): 1124-1134. doi:10.1056/NEJMsa050467
[24] Xia GL, Liu CB, Cao HL, et al. Prevalence of hepatitis B and C virus infections in the general Chinese population. Results from a nationwide cross-sectional seroepidemiologic study of hepatitis A, B, C, D, and E virus infections in China, 1992[J]. Int Hepatol Commun, 1996, 5(1): 62-73. doi:10.1016/S0928-4346(96)82012-3
[25] Songtanin B, Chaisrimaneepan N, Mendóza R, et al. Burden, outcome, and comorbidities of extrahepatic manifestations in hepatitis B virus infections[J]. Viruses, 2024, 16(4): 618. doi:10.3390/v16040618
[26] 原晶晶, 鲍诗平, 张帆, 等. 慢性乙型肝炎病毒感染与听力相关性初步研究[J]. 中国听力语言康复科学杂志, 2016, 14(6): 428-431 YUAN Jingjing, BAO Shiping, ZHANG Fan, et al. A preliminary study on the correction between chronic hepatitis B virus infection and hearing status[J]. Chinese Scientific Journal of Hearing and Speech Rehabilitation, 2016, 14(6): 428-431
[27] Nasab MS. Association between hepatitis B and hearing status[J]. Oman Med J, 2012, 27(5): 418-420. doi:10.5001/omj.2012.103
[28] 鲍诗平, 原晶晶, 张帆. 乙肝病毒携带者与慢性乙肝患者畸变产物耳声发射特征分析[J]. 听力学及言语疾病杂志, 2018, 26(1): 61-63 BAO Shiping, YUAN Jingjing, ZHANG Fan. Analysis of distortion product otoacoustic emissions in hepatitis B carrier and chronic hepatitis B patients with normal pure tone findings[J]. Journal of Audiology and Speech Pathology, 2018, 26(1): 61-63
[29] Bao SP. Association between hepatitis B and hearing status[J]. Eur Rev Med Pharmacol Sci, 2017, 21(5): 922-927
[30] Janssen HLA, van Zonneveld M, van Nunen AB, et al. Polyarteritis nodosa associated with hepatitis B virus infection. The role of antiviral treatment and mutations in the hepatitis B virus genome[J]. Eur J Gastroenterol Hepatol, 2004, 16(8): 801-807. doi:10.1097/01.meg.0000108362.41221.57
[31] Gozdas HT, Karabay O. Reversible bilateral ototoxicity in a patient with chronic hepatitis B during peginterferon alpha-2a treatment[J]. Indian J Pharmacol, 2015, 47(1): 121-122. doi:10.4103/0253-7613.150377
[32] Tunca A, Erbayrak M, Aytaç S, et al. Axonal neuropathy and hearing loss associated with alpha interferon treatment in chronic hepatitis B: a case report[J]. Turk J Gastroenterol, 2004, 15(2): 97-99
[33] Kanda Y, Shigeno K, Kinoshita N, et al. Sudden hearing loss associated with interferon[J]. Lancet, 1994, 343(8906): 1134-1135. doi:10.1016/s0140-6736(94)90237-2
[34] Jandl JH. The Anemia of liver disease: observations on its mechanism[J]. J Clin Invest, 1955, 34(3): 390-404. doi:10.1172/JCI103087
[35] Ye LT, Lai D, Tai JH. The association between Anemia and sensorineural hearing loss: a review[J]. Medicine, 2024, 103(44): e40326. doi:10.1097/MD.0000000000040326
[36] Azizul Islam S, Chung JW, Lee YS, et al. Negative association of hepatitis B virus with hearing impairment[J]. Am J Audiol, 2018, 27(3): 324-332. doi:10.1044/2018_AJA-17-0092
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