透析 接受化疗 长期服用免疫抑制剂及毒瘾者抗乙型肝炎病毒治疗探讨  

Therapy for HBV infection in dialysis patients,chemotherapy or immunosuppressive individuals and drug users

作　　者：宋术鹏[1] 兰英华[1] 李用国[1] 

机构地区：[1]哈尔滨医科大学附属第一医院感染科,哈尔滨150001

出　　处：《中国实用内科杂志》2014年第6期561-563,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家"十一五"重大科技专项(2008ZX10002-006);国家"十二五"重大科技专项2012ZX10002007)

摘　　要：目前对于透析、接受化疗及长期服用免疫抑制剂和毒瘾者合并乙型肝炎病毒(HBV)感染时,其抗病毒治疗均推荐选择强效、低耐药的核苷(酸)类似物治疗,不推荐干扰素治疗。对于透析者,当转氨酶和HBV-DNA水平未达到抗病毒治疗指征时,应考虑透析因素的影响,需积极行肝活检,以明确是否需要抗病毒治疗;对于化疗或者使用免疫抑制剂者,治疗前、治疗中、治疗后均需要密切监测乙型肝炎标志物,以确定是否需HBV治疗;对于毒瘾者,选择抗病毒治疗时机时应排除药物性肝损害的可能性。Currently,in dialysis patients, chemotherapy or immunosuppressive individuals and drug users with HBV infection, potent and low-resistance nucleos （t） ide analogues are recommended as the first-line treatment, hut interferon is not. For dialysis patients,when serum ALT levels and HBV DNA levels need not to accept antiviral therapy,we should consider the effect of dialysis and a liver biopsy should be conducted; For chemotherapy or immunosuppressive individuals, we should closely monitor HBV markers before, during and after treatment;For drug users with HBV infection, the possibility of druginduced liver damage need to be excluded for initiation of antiviral therapy.

关 键 词：透析者 化疗及长期服用免疫抑制剂者 毒瘾者 HBV感染 抗HBV治疗 

分 类 号：R512.62[医药卫生—内科学]