为何不停止对慢性乙型肝炎患者的抗病毒治疗

StephenW

Liver Int. 2018 Feb;38 Suppl 1:97-101. doi: 10.1111/liv.13627.
Why not to stop antiviral treatment in patients with chronic hepatitis B.
Marciano S1, Gadano A1.
Author information

1
    Liver Unit and Department of Research, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Abstract

Treatment of chronic hepatitis B with entecavir or tenofovir leads to viral suppression in almost all patients. However, prolonged or lifelong treatment is necessary. At present, there is no consensus among the three major guidelines for the treatment of chronic hepatitis B on whether or not to stop antiviral treatment. One of the main reasons for this controversy is that virological relapse has been well documented in patients with chronic hepatitis B who stop treatment. Relapse rate is particularly high in patients who are HBeAg-negative when treatment begins, with reported relapse rates of up to 70% 36 months after treatment discontinuation. Moreover, hepatic decompensation, jaundice and death have been described in patients with cirrhosis after treatment discontinuation. The main reason for stopping antiviral treatment is related to cost, however there is no robust evidence to support treatment discontinuation in most patients.
KEYWORDS:

antivirals; chronic hepatitis B; discontinuation; flare; nucleos(t)ide analogues

PMID:
    29427480
DOI:
    10.1111/liv.13627

StephenW

肝脏国际。 2018年2月; 38增刊1：97-101。 doi：10.1111 / liv.13627。
为何不停止对慢性乙型肝炎患者的抗病毒治疗
Marciano S1，Gadano A1。
作者信息

1
    肝脏部门和布宜诺斯艾利斯布宜诺斯艾利斯医院研究部，阿根廷布宜诺斯艾利斯。

抽象

用恩替卡韦或替诺福韦治疗慢性乙型肝炎导致几乎所有患者的病毒抑制。但是，长期或终身治疗是必要的。目前，关于慢性乙型肝炎治疗是否停止抗病毒治疗的三项主要指南尚未达成共识。这一争论的主要原因之一是病毒学复发在停止治疗的慢性乙型肝炎患者中已得到充分证实。治疗开始时HBeAg阴性患者的复发率特别高，停药后36个月复发率高达70％。此外，停止治疗后肝硬化患者的肝脏失代偿，黄疸和死亡已有描述。停止抗病毒治疗的主要原因与成本有关，但是没有强有力的证据支持大多数患者停止治疗。
关键词：

抗病毒药物;慢性乙型肝炎;停药;眩光。核苷（t）ide类似物

结论：
    29427480
DOI：
    10.1111 / liv.13627

StephenW

http://onlinelibrary.wiley.com/doi/10.1111/liv.13627/full

newchinabok

不停的好，因为核衣壳抑制马上出现（可以预见），联合应用是何结果，谁也不知。