摘要结核分枝杆菌（MTB）和乙型肝炎病毒（HBV）是影响人类健康的两大重要病原体，二者合并感染（MTB-HBV）在临床上不少见，其诊治面临多重挑战：MTB-HBV患者抗结核治疗中药物性肝损伤风险增高、抗MTB和HBV药物存在相互作用、MTB感染影响乙型肝炎相关肝癌/肝移植治疗策略选择等。目前国内外尚缺乏MTB-HBV患者的诊治共识。为了规范MTB-HBV的诊疗，国家感染性疾病临床医学研究中心（杭州）、中国医师协会感染科医师分会和浙江省医学会结核病学分会牵头组织专家，基于现有证据和临床经验制定本共识，旨在提高临床的诊治能力，降低药物性肝损伤、HBV激活、结核病加重、肝移植受者结核活动等风险，指导与规范MTB-HBV患者抗MTB及抗HBV治疗的实施。

abstractsMycobacterium tuberculosis（MTB）and hepatitis B virus（HBV）are two major pathogens that significantly impact global health. Coinfection with MTB and HBV（MTB-HBV）represents a clinically significant scenario posing multiple diagnostic and therapeutic challenges. These challenges encompass an elevated risk of drug-induced liver injury（DILI）during anti-tuberculosis therapy（ATT），potential drug-drug interactions between anti-MTB and anti-HBV regimens，and the impact of MTB infection on therapeutic strategies for HBV-related hepatocellular carcinoma（HCC）or liver transplantation. Currently，established consensus guidelines specifically addressing the management of MTB-HBV coinfection are lacking globally. To standardize the management of this coinfection，the National Clinical Research Center for Infectious Diseases（Hangzhou），the Infectious Diseases Branch of the Chinese Medical Doctor Association，and the Tuberculosis Branch of the Zhejiang Medical Association convened an expert panel to develop this consensus. Based on available evidence and clinical experience，this consensus aims to enhance clinical decision-making，mitigate risks including DILI，HBV reactivation，TB progression，and post-transplant MTB reactivation in liver recipients，and provide guidance for the optimal implementation of anti-MTB and anti -HBV therapies in patients with MTB -HBV coinfection.