扩大慢性乙型肝炎抗病毒治疗适应证:利大于弊  

Expanding the indications for antiviral therapy for chronic hepatitis B:Advantages and disadvantages

作　　者：韩超[1] 窦晓光[1] HAN Chao;DOU Xiaoguang(Department of Infectious Diseases,Shengjing Hospital of China Medical University,Shenyang 110022,China)

机构地区：[1]中国医科大学附属盛京医院感染科,沈阳110022

出　　处：《临床肝胆病杂志》2023年第1期22-26,共5页Journal of Clinical Hepatology

基　　金：国家科技重大专项课题(2017ZX10201201,2017ZX10202202);辽宁省科技厅应用基础研究计划项目(2022JH2/101500009)。

摘　　要：慢性乙型肝炎(CHB)是由乙型肝炎病毒(HBV)引起的慢性进展性疾病,如果没有得到及时有效的抗病毒治疗,最终都将发展为肝硬化、肝衰竭或肝细胞癌(HCC)等。尽早开始抗病毒治疗,可以阻止或延缓疾病进展,大大降低肝硬化、肝衰竭和HCC等发生。受目前抗病毒药物疗效的限制,抗病毒治疗适应证主要适用于HBV DNA阳性且ALT持续异常患者及HBV感染的一些特殊人群。然而部分未达到抗病毒治疗标准的患者疾病隐匿进展,导致不良临床结局。因此,国内外指南和共识都在不断扩大CHB抗病毒治疗适应证,使更多患者获益。Chronic hepatitis B(CHB)is a chronic progressive disease caused by hepatitis B virus(HBV),and without timely and effective antiviral therapy,it will eventually develop into liver cirrhosis,liver failure or hepatocellular carcinoma(HCC).Early initiation of antiviral therapy can prevent or delay disease progression and greatly reduce the incidence rates of liver cirrhosis,liver failure,and HCC.Due to the limited efficacy of current antiviral drugs,the indications for antiviral therapy are mainly applicable to patients with positive HBV DNA and persistent ALT abnormality and some special populations with HBV infection.However,some patients who cannot reach the criteria for antiviral therapy may have insidious disease progression,leading to adverse clinical outcomes.Therefore,the guidelines and consensus statements in China and globally are constantly expanding the indications for antiviral therapy for CHB,so as to bring benefits to more patients.

关 键 词：慢性乙型肝炎 治疗学 适应证 

分 类 号：R512.62[医药卫生—内科学]