病毒性遗传变异和基因型如何影响乙肝的疾病和治疗结果？

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How viral genetic variants and genotypes influence disease and treatment outcome of chronic hepatitis B. Time for an individualised approach?
Author links open overlay panelNeilRajoriya1ChristopheCombet2FabienZoulim23Harry L.A.Janssen1
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https://doi.org/10.1016/j.jhep.2017.07.011Get rights and content
Summary
Chronic hepatitis B virus (HBV) infection remains a global problem. Several HBV genotypes exist with different biology and geographical prevalence. Whilst the future aim of HBV treatment remains viral eradication, current treatment strategies aim to suppress the virus and prevent the progression of liver disease. Current strategies also involve identification of patients for treatment, namely those at risk of progressive liver disease. Identification of HBV genotype, HBV mutants and other predictive factors allow for tailoured treatments, and risk-surveillance pathways, such as hepatocellular cancer screening. In the future, these factors may enable stratification not only of treatment decisions, but also of patients at risk of higher relapse rates when current therapies are discontinued. Newer technologies, such as next-generation sequencing, to assess drug-resistant or immune escape variants and quasi-species heterogeneity in patients, may allow for more information-based treatment decisions between the clinician and the patient.

This article serves to discuss how HBV genotypes and genetic variants impact not only upon the disease course and outcomes, but also current treatment strategies. Adopting a personalised genotypic approach may play a role in future strategies to combat the disease. Herein, we discuss new technologies that may allow more informed decision-making for response guided therapy in the battle against HBV.

Keywords
Hepatitis BGenotypePersonalised medicine

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病毒性遗传变异和基因型如何影响慢性乙型肝炎的疾病和治疗结果？个体化方法的时间？
作者链接打开覆盖面板NeilRajoriya1ChristopheCombet2FabienZoulim23Harry L.A.Janssen1
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https://doi.org/10.1016/j.jhep.2017.07.011获取权利和内容
概要
慢性乙型肝炎病毒（HBV）感染仍然是一个全球性问题。存在几种HBV基因型，具有不同的生物学和地理流行性。虽然HBV治疗的未来目标仍然是病毒根除，但目前的治疗策略旨在抑制病毒并预防肝病的发展。目前的策略还包括鉴别待治疗的患者，即那些处于进行性肝病风险中的患者。乙型肝炎病毒基因型，乙型肝炎病毒突变和其他预测因素的鉴定允许适当的治疗和风险监视通路，如肝细胞癌筛查。在未来，这些因素不仅可以使治疗决定分层，而且可以使当前治疗中止时具有更高复发率风险的患者分层。较新的技术，例如下一代测序技术，评估患者的耐药或免疫逃逸变异和准种异质性，可能允许临床医生和患者之间更多基于信息的治疗决策。

本文旨在讨论HBV基因型和遗传变异不仅影响疾病进程和结果，而且影响目前的治疗策略。采取个性化的基因型方法可能在未来的战略中发挥作用，以对抗这种疾病。在这里，我们讨论新的技术，可能会让更多的知情决策响应指导治疗在抗击乙肝病毒。

关键词
乙型肝炎基因型个性化药物