慢性乙型肝炎抗病毒治疗与低病毒血症管理策略研究进展
Antiviral therapy of chronic hepatitis B and progress of research on strategies for management of low-level viremia
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摘要: 长期持续的HBV感染可导致肝硬化及肝癌等严重并发症,慢性乙型肝炎(CHB)患者的总体治疗目标为长期抑制HBV复制并减轻肝脏损伤,减少并发症发生,延长生存时间。目前的主要抗病毒治疗药物是核苷(酸)类似物(NAs)和干扰素(IFN),但部分接受长期抗病毒治疗的患者仍会出现低病毒血症(LLV),LLV与肝癌及不良预后密切相关。本综述探讨CHB患者的抗病毒治疗现状,分析目前主要口服抗病毒药物的LLV发生率,探讨LLV的高危因素、可能的机制及现有的管理策略,以期优化CHB的长期治疗方案,提高患者的生存质量。Abstract: Long-term and persistent hepatitis B virus(HBV) infection may lead to severe complications such as liver cirrhosis and liver cancer. The overall objective of the treatment of the Chronic hepatitis B(CHB) patients is long-term inhibition of HBV replication, alleviation of liver damage, reduction of complications, and extension of survival time. At present, nucleos(t)ide analogues(Nas) and interferons(IFN) are the major drugs for antiviral therapy, however, some of the patients who receive long-term antiviral therapy still have low-level viremia(LLV). The LLV is closely associated with liver cancer and poor prognosis. The review focuses on the current status of antiviral treatment of the CHB patients and the incidence of LLV among the patients who are treated with oral administration of major antiviral drugs, further explores the high-risk factors, potential mechanisms and current management strategies for LLV so as to optimize the therapeutic regimen for long-term treatment of CHB and improve the quality of life.
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