慢性乙型肝炎病毒感染管理的改进。

StephenW

Expert Rev Gastroenterol Hepatol. 2018 Sep 29. doi: 10.1080/17474124.2018.1530986. [Epub ahead of print]
Improvements in the Management of Chronic Hepatitis B Virus Infection.
Liu LZ1, Sun J1, Hou J1, Chan HLY2.
Author information

1
    a Department of Infectious Diseases , Nanfang Hospital, Southern Medical University , Guangzhou , China.
2
    b Department of Medicine and Therapeutics and Institute of Digestive Disease , The Chinese University of Hong Kong , Hong Kong SAR , China.

Abstract

The primary goals of managing chronic hepatitis B (CHB) are prevention of liver-related complications and reduction of mortality. Universal vaccination has dramatically reduced the incidence of new infection, but the management of existing CHB patients are still challenging. Areas covered: This review compares the similarities and differences among the latest published regional guidelines on the indications and choices of antiviral therapy. We have summarized advances in virological biomarkers and non-invasive tests for liver fibrosis in disease assessment. Benefits and remaining challenges of current standard of care by peginterferon and nucleos(t)ide analogues (NA) have been presented . Data on combination therapy of peginterferon and NA in seeking functional cure of the disease is also critically discussed. We have also described the improvement in the management of CHB at pregnancy and prophylaxis in patients on chemotherapy and immunosuppressants. Expert commentary: Controversies exist in the assessment of disease activity for selection patients for treatment as well as on the use of tenofovir alafenamide as a safe and cost-effective alternative to tenofovir disoproxil fumarate. Though combination therapy of peginterferon and NA has induced HBsAg seroclearance in a small proportion of patients, peginterferon is not preferred in the future trend of drug development.
KEYWORDS:

Cirrhosis; Entecavir; Fibroscan; Functional Cure; HBsAg; Hepatocellular Carcinoma; Peginterferon; Tenofovir

PMID:
    30269597
DOI:
    10.1080/17474124.2018.1530986

StephenW

专家Rev Gastroenterol Hepatol。 2018年9月29日。土井：10.1080 / 17474124.2018.1530986。 [提前打印]
慢性乙型肝炎病毒感染管理的改进。
Liu LZ1，Sun J1，Hou J1，Chan HLY2。
作者信息

1
    南方医科大学南方医院感染科，广州
2
    b香港中文大学医学与治疗学系和消化系疾病研究所，中国香港特别行政区。

抽象

管理慢性乙型肝炎（CHB）的主要目标是预防肝脏相关并发症和降低死亡率。普遍接种疫苗大大降低了新感染的发生率，但现有CHB患者的管理仍然具有挑战性。涵盖的领域：本综述比较了最新发布的关于抗病毒治疗适应症和选择的区域指南之间的异同。我们总结了病毒学生物标志物的进展和疾病评估中肝纤维化的非侵入性检测。已经提出了聚乙二醇干扰素和核苷（t）ide类似物（NA）的当前护理标准的益处和剩余挑战。关于聚乙二醇干扰素和NA的联合治疗在寻找疾病的功能性治疗方面的数据也得到了批判性的讨论。我们还描述了妊娠期CHB管理的改善以及化疗和免疫抑制剂患者的预防。专家评论：选择治疗患者的疾病活动评估以及使用替诺福韦艾拉酚胺作为替诺福韦地索普西富马酸盐的安全且具有成本效益的替代品存在争议。尽管聚乙二醇干扰素和NA的联合治疗在一小部分患者中诱导了HBsAg血清清除，但聚乙二醇干扰素在药物开发的未来趋势中不是优选的。
关键词：

肝硬化;恩替卡韦; Fibroscan的;功能性治疗;乙肝表面抗原;肝细胞癌;聚乙二醇干扰素;替诺福韦

结论：
    30269597
DOI：
    10.1080 / 17474124.2018.1530986

neilhbver

意思是TDF还是最优之选相对于taf