|
- 现金
- 62111 元
- 精华
- 26
- 帖子
- 30437
- 注册时间
- 2009-10-5
- 最后登录
- 2022-12-28
|
<http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04555.x/abstract>
评论文章：慢性乙型肝炎-抗病毒或免疫调节治疗？
Review article: chronic hepatitis B – anti-viral or immunomodulatory
therapy?
V. Rijckborst, M. J. Sonneveld, H. L. A. Janssen
Article first published online: 29 DEC 2010
DOI: 10.1111/j.1365-2036.2010.04555.x
© 2010 Blackwell Publishing Ltd
Issue
Alimentary Pharmacology & Therapeutics
Volume 33, Issue 5, pages 501–513, March 2011
Aliment Pharmacol Ther 2011; 33: 501–513
Summary
Background First-line treatment options for chronic hepatitis B (CHB)
consist of nucleos(t)ide analogues with a high barrier to resistance
(entecavir and tenofovir) or the immunomodulatory agent peginterferon
(PEG-IFN). The optimal choice for individual patients remains
controversial.
Aim To review treatment options for CHB, with a focus on deciding
between prolonged nucleos(t)ide analogue therapy or a finite course of
PEG-IFN.
Methods A comprehensive literature search was undertaken.
Results Long-lasting, treatment-maintained suppression of hepatitis B
virus (HBV) DNA without resistance is achievable in most patients by
entecavir or tenofovir. A sustained off-treatment response is, however,
unlikely and long-term therapy must be anticipated. PEG-IFN offers a higher
rate of sustained response in a subgroup of patients, but is frequently
complicated by side effects. Pre-treatment predictors of response,
including HBV genotype, alanine aminotransferase and HBV DNA levels, aid in
selecting patients for PEG-IFN therapy. Furthermore, on-treatment markers
such as quantitative hepatitis B surface antigen may be applied to identify
nonresponders early during the PEG-IFN treatment course, thereby preventing
unnecessary treatment.
Conclusions Both nucleos(t)ide analogues and PEG-IFN can be prescribed
as first-line treatment options for CHB. However, PEG-IFN should only be
considered for patients with a high chance of response based on
pre-treatment and on-treatment factors. |
|
发表于 2011-6-10 17:11
