[英语，研究]Evaluation of current treatment recommendations for chronic hep

StephenW

<http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06623.x/abstract>

Evaluation of current treatment recommendations for chronic hepatitis B: A
2011 update

Myron John Tong1,2,*, Leeyen Hsu2, Patrick W Chang2, Lawrence Mitchell
Blatt2Article first published online: 13 APR 2011

DOI: 10.1111/j.1440-1746.2011.06623.x
© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell
Publishing Asia Pty Ltd Issue

Journal of Gastroenterology and Hepatology
Volume 26, Issue 5, pages 829–835, May 2011

Abstract

Background and Aim:  Guidelines for the treatment of chronic hepatitis B
have been recently updated in the 2009 European Association for the Study
of the Liver consensus statement, the 2008 US Panel, the 2008
Asian–Pacific consensus statement, and the 2009 American Association for
the Study of Liver Disease practice guidelines. We sought to determine
whether these guidelines identified patients who developed hepatocellular
carcinoma (HCC) or who died of non-HCC liver-related deaths for antiviral
therapy.

Methods:  The criteria described in the new treatment guidelines were
matched to the database of 369 hepatitis B surface antigen-positive
patients, in whom 30 developed HCC and 37 died of non-HCC liver-related
deaths during a mean follow up of 84 months. Results:  Using criteria for
antiviral therapy as stated by the four current guidelines, 19–30% of
patients who died of non-HCC liver-related complications, and 23–53% of
patients who developed HCC, would have been excluded for antiviral therapy.
If baseline serum albumin levels of ≤ 3.5 g/dL or platelet counts of ≤
130 000 mm3 were included into the treatment criteria, then 85–94% of
patients who developed liver-related complications would have been
recommended for antiviral therapy. Also, the addition of precore A1896
mutants and basal core promoter T1762/A1764 mutants would have identified
98.5–100% of these patients.

Conclusion:  The updated treatment guidelines for hepatitis B still
excluded patients who developed serious liver-related complications. The
inclusion of baseline serum albumin and platelet counts to current criteria
would have identified a majority of these patients for antiviral therapy.
These tests should be included into hepatitis B treatment strategies.

StephenW

评价慢性乙肝目前的治疗建议：
2011年更新

迈伦约翰彤，2，*，Leeyen Hsu2，帕特里克W长2，劳伦斯米切尔
Blatt2Article首次在网上公布：2011年4月13日

分类号：10.1111/j.1440-1746.2011.06623.x
© 2011年胃肠病学和肝病基金会和Blackwell
亚洲私人有限公司出版发行

胃肠病学和肝病
26卷第5期，页829-835，2011年5月

摘要

背景与目的：对慢性乙型肝炎治疗指引
最近已经更新了2009年欧洲研究协会
肝脏的共识声明中，2008年美国小组，2008
亚太共识声明，以及2009年美国协会
肝病的实践指南的研究。我们试图确定
是否确定肝癌患者谁开发这些准则
肝癌（HCC）或谁非肝癌肝病毒有关的死亡而死
治疗。

方法：在新的治疗指南中规定的标准是
相匹配的369乙型肝炎表面抗原阳性数据库
患者，其中30和37开发死于肝癌非肝癌肝有关
平均随访期间死亡84个月。结果：使用标准
经抗病毒治疗指引中所述的4个电流，19-30％的
患者谁非肝癌肝相关并发症死亡，23-53％的
肝癌患者谁开发，将被排除在外的抗病毒治疗。
如果基线血清≤≤3.5克/升或血小板计数白蛋白水平
130零零零立方毫米进了治疗标准包括在内，那么85-94％的
肝脏病人谁开发有关的并发症，会被
推荐用于抗病毒治疗。另外，除了前C区A1896变异
突变体和基本核心启动子T1762/A1764突变会已确定
98.5-100％，这些病人。

结论：B型肝炎最新治疗指南仍
排除严重肝患者谁开发有关的并发症。该
基线血清白蛋白和血小板计数列入现行标准
将已确定的抗病毒治疗这些患者多数。
这些测试应纳入乙型肝炎的治疗策略。