Monitoring of Patients Who Are Not Candidates for Therapy Summary
Patients who are not candidates for immediate anti-HBV therapy should be closely monitored[Terrault 2016; Lok 2009]
HBeAg-positive patients with immunotolerant disease should receive liver function tests every 3-6 months and HBeAg tests every 6-12 months
HBeAg-negative patients who are inactive HBsAg carriers should be assessed every 3 months during the first year and biannually thereafter
Patients with low HBV DNA and HBsAg levels may need less frequent monitoring
Patients who are not candidates for immediate initiation of therapy should be closely monitored. Hepatitis B e antigen (HBeAg)–positive patients with HBV DNA > 20,000 IU/mL but normal ALT levels and an absence of necroinflammation on the liver biopsy (ie, so-called immunotolerant patients) should have their alanine aminotransferase (ALT) levels measured at least every 6 months and should be regularly tested for the presence of HBeAg (approximately every 6-12 months)(Management Guidelines).[Terrault 2016; Lok 2009] In HBeAg-negative patients with HBV DNA < 2000 IU/mL and normal ALT (ie, so-called inactive hepatitis B surface antigen [HBsAg] carriers), ALT and HBV DNA levels should be reassessed every 3 months during the first year, with subsequent biannual assessments.[Lok 2009] Patients with low levels of serum HBV DNA (< 2000 IU/mL), as well as low levels of HBsAg (< 1000 IU/mL), may perhaps require less frequent monitoring due to a very low probability of disease reactivation. [Brunetto 2010]
作者：Harry L. A. Janssen，MD，PhD;米兰J. Sonneveld，硕士（更多信息）
总编辑：Stefan Zeuzem，MD
最新评论：2/24/17（最新消息）
监测不适合治疗的患者
概要
不应立即进行抗HBV治疗的患者应密切监测[Terrault 2016; Lok 2009]
HBeAg阳性患者免疫耐受性疾病每3-6个月应接受肝功能检查，每6-12个月进行HBeAg检测
HBeAg阴性的HBsAg阴性患者应在第一年每3个月进行一次评估，
低HBV DNA和HBsAg水平的患者可能需要较少的监测
不应立即开始治疗的患者应密切监测。乙型肝炎病毒抗原（HBeAg）阳性患者HBV DNA> 20,000 IU / mL，但正常的ALT水平和肝脏活检中不存在坏死性炎症（即所谓的免疫耐受患者）应测量其丙氨酸氨基转移酶（ALT）水平至少每6个月一次，应经常测试HBeAg的存在（大约每6-12个月）（管理指南）。 [Terrault 2016; Lok 2009]在HBV DNA <2000 IU / mL和正常ALT（即所谓的活跃乙型肝炎表面抗原（HBsAg）携带者）的HBeAg阴性患者中，ALT和HBV DNA水平应每3个月重新评估第一年，由于非常低（<1000 IU / mL）以及低水平的HBsAg（<1000 IU / mL），（<1000 IU / mL）可能需要较少的监测，疾病重新激活的概率Netto 2010