The Management of Chronic Hepatitis B in Asian Americans

StephenW

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Dis Sci  |  Posted 4 days ago

The Management of Chronic Hepatitis B in Asian Americans

Tong MJ, Pan CQ, Hann HW, Kowdley KV, Han SH, Min AD, Leduc TS;

Digestive Diseases and Sciences (Sep 2011)

Hepatitis B virus (HBV) infection is common with major clinical
consequences worldwide. In Asian Americans, the HBsAg carrier rate ranges
from 7 to 16%; HBV is the most important cause of chronic hepatitis,
cirrhosis, and hepatocellular carcinoma (HCC). Patients are first diagnosed
at different stages of clinical disease, which is categorized by
biochemical and virologic tests. Patients at risk for liver complications
should be identified and offered antiviral therapy. The two antiviral
agents recommended for first-line treatment of chronic hepatitis B (CHB)
are entecavir and tenofovir. The primary goal of therapy is sustained
suppression of viral replication to achieve clinical remission, reverse
fibrosis, and prevent and reduce progression to end-stage liver disease and
HCC. Asian patients with chronic hepatitis, either HBeAg-positive or
-negative, with HBV DNA levels>10(4) copies/mL (>2,000 IU/mL) and alanine
aminotransferase (ALT) values above normal are candidates for antiviral
therapy. HBeAg-negative patients with HBV DNA>10(4) copies/mL (>2,000
IU/mL) and normal ALT levels but who have either serum albumin ≤3.5 g/dL
or platelet count ≤130,000 mm(3), basal core promoter mutations, or who
have first-degree relatives with HCC should be offered treatment. Patients
with cirrhosis and detectable HBV DNA must receive antiviral therapy.
Considerations for treatment include pregnant women with high viremia,
coinfected patients, and those requiring immunosuppressive therapy. In
HBsAg-positive patients with risk factors, lifelong surveillance for HCC
with alpha-fetoprotein testing and abdominal ultrasound examination at
6-month intervals is required. These recommendations are based on a review
of relevant literature and the opinion of a panel of Asian American
physicians with expertise in hepatitis B treatment.

StephenW

[谷歌翻译
不是100％正确，仅供参考使用。]

在亚裔美国人的慢性乙型肝炎管理

童兆焦耳，潘CQ，翰硬件，Kowdley千伏，韩SH，闵公元，勒杜克TS;

消化系统疾病和科学（2011年9月）

乙型肝炎病毒（HBV）感染是很常见的主要临床的
后果世界各地。在亚裔美国人中，HBsAg携带率范围
从7至16％;乙型肝炎病毒是慢性肝炎的最重要原因，
肝硬化和肝细胞癌（HCC）。首次确诊患者
在不同阶段的临床疾病，这是分类
生化和病毒学检查。患者的肝脏并发症的风险
应确定和提供抗病毒治疗。两种抗病毒药
代理商建议第一线治疗慢性乙型肝炎（CHB）
恩替卡韦和替诺福韦。治疗的首要目标是持续
抑制病毒复制，以达到临床缓解，扭转
纤维化，防止和减少进展到终末期肝病和
肝癌。亚洲与慢性肝炎患者，无论是HBeAg阳性或
阴性，HBV DNA水平> 10（4）拷贝/毫升（> 2000 IU /毫升）和丙氨酸
转氨酶（ALT）值高于正常抗病毒药物的候选人
治疗。 HBeAg阴性患者HBV - DNA> 10（4）拷贝/毫升（> 2,000
国际单位/毫升）和ALT正常水平，但无论是血清白蛋白≤3.5 g / dL的
或血小板计数≤130,000毫米（3），基础核心启动子突变，或谁
与肝癌的一级亲属应给予治疗。患者
肝硬化和HBV - DNA检测的，必须接受抗病毒药物治疗。
接受治疗的注意事项，包括与高病毒血症的孕妇，
合并感染的病人，以及那些需要接受免疫抑制治疗。在
HBsAg阳性患者的危险因素，肝癌的终身监控
甲胎蛋白检测和腹部超声检查
6个月的时间间隔是必需的。这些建议的基础上检讨
有关文献和亚裔美国人面板的意见
医生在治疗乙肝的专长。