抗病毒治疗之前丙型肝炎的人应测试乙肝

StephenW

People with Hepatitis C Should Be Tested for Hepatitis B

Before Starting Antiviral Therapies
(September 16, 2016) – All patients beginning hepatitis C (HCV) treatment using direct acting antiviral (DAA) therapies should be assessed for hepatitis B (HBV), according the American Association for the Study of Liver Diseases/Infectious Diseases Society of America Guidance Panel, which provides up-to-date guidance on the treatment of hepatitis C on its website, HCVguidelines.org.
“Cases of HBV reactivation (an increase of the HBV virus) during or after DAA therapy for HCV have been reported in HBV/HCV co-infected patients who were not already on HBV suppressive therapy,” explains Raymond Chung, MD, co-chair of the HCV Guidance Panel. “The severity of these cases have ranged from mild to severe fulminant liver injury that can be life threatening. While we do not know how frequently this occurs, the Guidance Panel recommends HBV testing for all patients beginning DAA treatment for HCV.”
Additionally, the Guidance Panel recommends:
·         HBV vaccination for all susceptible individuals (i.e., those not immunized or without evidence of response to immunization)
·         Obtaining a test for HBV DNA prior to DAA therapy in patients who could be actively replicating (i.e., those who are HBsAg positive)
·         Starting patients who meet criteria for treatment of active HBV infection on therapy at the same time — or before — HCV DAA therapy is started
·         Monitoring patients with low or undetectable HBV DNA levels at regular intervals (usually not more frequently than every four weeks) for HBV reactivation during treatments and placing those whose HBV DNA levels meet treatment criteria on HBV therapy as recommended by the AASLD’s HBV treatment guidelines
”While there currently isn’t enough data to make clear recommendations for patients who have been exposed to HBV and resolved the virus, whether spontaneous or after antiviral therapy, we recommend these patients be monitored for HBV reactivation,” says Susanna Naggie, MD, MHS, co-chair of the HCV Guidance Panel. “This is particularly important in the event of unexplained increases in liver enzymes and during and/or after completion of DAA therapy.”
Visit HCVguidelines.org for more information about these newest recommendations and to view other sections of the HCV Guidance.

StephenW

丙型肝炎的人应测试的乙肝
抗病毒治疗之前丙型肝炎的人应测试的乙肝
开始之前的抗病毒治疗
（2016年9月16日） - 全部采用直接作用的抗病毒开始丙肝（HCV）治疗的患者（DAA）疗法应评估乙型肝炎（HBV），根据美国肝病/美国传染病学会的研究指导小组，其中提供了关于丙型肝炎在其网站上，HCVguidelines.org治疗了最新的指导。
“期间或丙型肝炎病毒有报道谁是不是已经对乙肝病毒抑制治疗HBV / HCV合并感染患者DAA治疗后HBV再激活（增加了乙肝病毒）的案例，”锺博士，联席主席解释的HCV指导小组。 “这些案件的严重性已范围从轻微到严重暴发性肝损伤，可危及生命。虽然我们不知道如何经常发生这种情况，指导小组建议开始DAA治疗HCV所有患者HBV测试“。
此外，指导小组建议：
·对所有易感人群乙肝疫苗（即，那些没有接种或没有回应免疫的证据）
·前DAA治疗获得了HBV DNA测试的患者谁也积极复制（即，那些谁是HBsAg阳性）
·开始谁符合标准，同时对治疗积极治疗HBV感染患者 - 或之前 - DAA治疗HCV启动
·在处理定期监测患者低或不可检测HBV DNA水平（通常不超过每四周更频繁地），用于HBV再激活，并把那些HBV DNA水平满足对HBV疗法治疗标准所推荐的AASLD的乙肝病毒治疗指南
“虽然目前还没有足够的数据，使患者明确的建议谁已经暴露HBV和解决的病毒，无论是自发或抗病毒治疗后，我们建议这些患者中的HBV再监测，”苏珊娜Naggie，MD说： MHS，丙型肝炎病毒指导小组的联合主席。 “这是在肝酶和过程中和/或DAA治疗完成后不明原因的增加事件尤为重要。”
访问HCVguidelines.org有关这些最新建议的详细信息，并查看HCV指导的其他部分。