过去几十年的临床和基础研究在对慢性乙型肝炎病毒（HBV）感染的认识以及慢性乙型肝炎和HBV-肝硬化的管理方面取得了共识。然而，已经出现了对概念和/或定义中现有共识的有争议的挑战。其中包括 (1)。丙氨酸氨基转移酶正常上限：传统实验室定义 vs 固定； (2)。慢性 HBV 感染阶段的命名法：经典与 EASL 建议； (3)。抗病毒治疗的适应症：治疗患者 vs 治疗 HBV； (4)。有限与无限期的长期抗病毒治疗：A. HBV 肝硬化的有限治疗； B. 再治疗决定：生化标志物 vs HBsAg/ALT 动力学。基于相关科学证据，对这些争议性问题的利弊进行了回顾、评估和深入讨论，旨在澄清或解决这些争议性问题。作者: StephenW 时间: 2022-10-28 14:37
Perspectives on current controversial issues in the management of chronic HBV infection
Yun-Fan Liaw
Journal of Gastroenterology volume 57, pages 828–837 (2022)Cite this article
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Abstract
Clinical and basic research in the past decades has achieved consensus in the understanding of chronic hepatitis B virus (HBV) infection and the management of chronic hepatitis B and HBV-cirrhosis. However, debatable challenges to the existing consensus in the concept and/or definitions have emerged. These include (1). alanine aminotransferase upper limit of normal: traditional laboratory-defined vs fixed; (2). nomenclature for phases of chronic HBV infection: classical vs EASL proposal; (3). indication of antiviral therapy: to treat patients vs to treat HBV; (4). finite vs indefinite long-term antiviral therapy: A. finite therapy in HBV-cirrhosis; B. retreatment decision: biochemical markers vs HBsAg/ALT kinetics. The pros and cons of these controversial issues were reviewed, assessed, and discussed in depth based on relevant lines of scientific evidence, intended to clarify or solve these controversial issues.