StephenW 发表于 2011-4-3 10:17
Precisely. But existing anti-virals cannot clear HbSag as the diagrams clearly show. I am trying t ...
2009 EASL(欧洲肝脏研究学会)乙肝诊治指南中涉及的三个乙肝治疗终点: (1) 对于HBeAg阳性和HBeAg阴性患者,最理想的治疗终点是持续的HBsAg清除,伴或不伴抗HBs抗体出现。这关系到慢性肝炎活动性完全并明确的缓解和长期转归的改善。 In HBeAg-positive and HBeAg-negative patients, the ideal end-point of therapy is sustained HBsAg loss with or without seroconversion to anti-HBs. This is associated with a complete and definitive remission of the activity of chronic hepatitis B and an improved long-term outcome . (2) 在HBeAg阳性患者中,持久的HBeAg血清转换是满意的终点,因为已经证实其与预后改善相关。 In HBeAg-positive patients, durable HBe seroconversion is a satisfactory end-point because it has been shown to be associated with improved prognosis. (3)未达到HBeAg血清转换的HBeAg阳性患者以及HBeAg阴性患者,经核苷类似物治疗后,维持HBV DNA在检测不到水平或经干扰素治疗后,HBV DNA持续检测不到,是另一个最满意的治疗终点。 In HBeAg-positive patients who do not achieve HBe seroconversion, and in HBeAg-negative patients, a maintained undetectable HBV DNA level on treatment with NUCs or a sustained undetectable HBV DNA level after interferon therapy is the next most desirable endpoint. 首先,欧洲肝脏病学会早就已经认可了HBsAg清除是乙肝治疗(治疗的话肯定是药物治疗吧?)的最理想的终点。 1. 如果HBsAg不能被清除的话,欧洲肝脏病学会设立这一治疗终点有和意义?那岂不是说明欧洲人对乙肝理论研究的不透彻? 现在认可的观点是HBsAg肯定可以被清除,只是清除的途径还不是很清除。 2. 为何乙肝不能被治愈,现在普遍认为是cccDNA(中文名字:闭合环状DNA)在作怪,因为他很难被清除。欧洲肝脏病学会的这一观点,即把HBsAg清除作为主要的治疗终点,我想他的理论基础一定是认可HBsAg和cccDNA的内在联系。否则,欧洲人为何不把HBcAb或者别的其他Marker作为乙肝治疗的最理想终点? |