一线核苷(酸)类似物经治的慢性乙型肝炎患者低病毒血症的发生及治疗策略  

Low-level viremia in chronic hepatitis B patients treated with first-line treatment with nucleos(t)ide analogues and its treatment strategies

作　　者：郑嵘炅[1] 鲁晓擘[1] ZHENG Rongjiong;LU Xiaobo(Center of Infectious Diseases,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院感染性疾病中心,乌鲁木齐830054

出　　处：《临床肝胆病杂志》2024年第5期880-883,共4页Journal of Clinical Hepatology

摘　　要：强效低耐药口服抗病毒治疗可使HBV复制受到强力抑制,但部分患者接受恩替卡韦、替诺福韦酯、丙酚替诺福韦、艾米替诺福韦治疗48周及以上仍存在低病毒血症(LLV)。国内外多项研究结果提示,抗病毒治疗后LLV与慢性乙型肝炎肝纤维化进展、失代偿期肝硬化和肝细胞癌发生风险以及长期生存率降低密切相关。因此,本文聚焦有关一线核苷(酸)类似物治疗后LLV的发生及其危险因素和临床危害以及不同的治疗方案,以期为今后慢性乙型肝炎患者LLV的治疗提供参考。Highly effective oral antiviral therapy with low drug resistance can strongly inhibit HBV replication;however,some patients may still have low-level viremia(LLV)after receiving entecavir,tenofovir disoproxil fumarate,tenofovir alafenamide,or tenofovir amibufenamide for 48 weeks or more.Multiple studies in China and globally show that LLV after antiviral therapy is closely associated with the progression of chronic hepatitis B liver fibrosis,the risk of decompensated liver cirrhosis and hepatocellular carcinoma,and the reduction in long-term survival rate.Therefore,this article reviews the development,risk factors,and clinical harm of LLV after first-line treatment with nucleos(t)ide analogues,as well as different treatment regimens,in order to provide a reference for the treatment of LLV in chronic hepatitis B patients in the future.

关 键 词：乙型肝炎 慢性 核苷类 核苷酸类 低病毒血症 

分 类 号：R512.62[医药卫生—内科学]