乙型肝炎治疗的争议：肝细胞癌

StephenW

乙型肝炎治疗的争议：肝细胞癌
斯图尔特·K·罗伯茨 1、阿马尔·马吉德 2、威廉·肯普 2
隶属关系
隶属关系

    1
    The Alfred, 55 Commercial Road, Melbourne 3004, Australia;澳大利亚墨尔本莫纳什大学。电子地址：[email protected]。
    2
    The Alfred, 55 Commercial Road, Melbourne 3004, Australia;澳大利亚墨尔本莫纳什大学。

    PMID：34593153 DOI：10.1016/j.cld.2021.06.006

抽象的

乙型肝炎是全球肝细胞癌 (HCC) 的主要原因。慢性乙型肝炎患者未经治疗的年 HCC 发病率在非肝硬化患者中为 0.4%，在肝硬化患者中为 2% 至 3%。建议对包括儿童在内的高危人群每隔 6 个月进行一次有/无甲胎蛋白的超声监测。使用恩替卡韦或替诺福韦对慢性乙型肝炎进行抗病毒治疗可显着降低肝病所有阶段的 HCC 风险，并降低治愈性治疗后 HCC 复发的风险。没有足够的数据推荐在预防新发或复发性 HCC 治愈后治疗中使用替诺福韦而不是恩替卡韦。

关键词：抗病毒治疗；乙型肝炎;肝细胞癌;预测模型；风险因素;筛选。

版权所有 © 2021 Elsevier Inc。保留所有权利。

StephenW

Controversies in the Management of Hepatitis B: Hepatocellular Carcinoma
Stuart K Roberts  1 , Ammar Majeed  2 , William Kemp  2
Affiliations
Affiliations

    1
    The Alfred, 55 Commercial Road, Melbourne 3004, Australia; Monash University, Melbourne, Australia. Electronic address: [email protected].
    2
    The Alfred, 55 Commercial Road, Melbourne 3004, Australia; Monash University, Melbourne, Australia.

    PMID: 34593153 DOI: 10.1016/j.cld.2021.06.006

Abstract

Hepatitis B is the leading cause of hepatocellular cancer (HCC) worldwide. Untreated, annual HCC incidence rates in chronic hepatitis B subjects are 0.4% in noncirrhotics and 2% to 3% in cirrhotics. Surveillance with ultrasound with/without α-fetoprotein at 6-month intervals is recommended in at-risk persons including children. Antiviral therapy in chronic hepatitis B with entecavir or tenofovir significantly lowers the risk of HCC across all stages of liver disease, and lowers the risk of HCC recurrence following curative therapy. There are insufficient data to recommend use of tenofovir over entecavir in the prevention of de novo or recurrent HCC postcurative therapy.

Keywords: Antiviral therapy; Hepatitis B; Hepatocellular carcinoma; Predictive models; Risk factors; Screening.

Copyright © 2021 Elsevier Inc. All rights reserved.