慢性乙型肝炎的临床管理：简要概述

StephenW

慢性乙型肝炎的临床管理：简要概述
Arno Furquim d'Almeida 1 2 , Erwin Ho 1 2 , Stijn Van Hees 1 2 , Thomas Vanwolleghem 1 2
隶属关系
隶属关系

    1
    比利时安特卫普安特卫普大学医院胃肠病学和肝病学系。
    2
    比利时安特卫普安特卫普大学实验医学和儿科实验室病毒性肝炎研究小组。

    PMID：34846093 DOI：10.1002/ueg2.12176

抽象的

全世界有超过 2.5 亿人慢性感染乙型肝炎病毒 (HBV)。受感染的患者发生肝脏相关并发症的风险高达 100 倍，包括肝硬化、肝功能失代偿和肝细胞癌。尽管如此，大多数感染仍然没有症状，这强调了 HBV 筛查和与护理联系的重要性。在核苷（酸）类似物 (NA) 治疗期间可以看到出色的临床结果，由于缺乏功能性治愈，这种治疗通常会不确定地继续。越来越多的证据表明，在没有功能性治愈的患者中，长期治疗后停用 NA 诱导病毒抑制可能是一个有利的选择。然而，迫切需要可靠的生物标志物来选择将从 NA 戒断中受益的患者。此外，改进筛查和护理联系的更新和新颖方法是优化慢性乙型肝炎临床管理的其他基本因素。

关键词：慢性乙型肝炎；临床管理；核苷（酸）类似物；筛选；治疗中断。

© 2021 作者。由 Wiley Periodicals LLC 代表 United European Gastroenterology 出版的 United European Gastroenterology Journal。

StephenW

Clinical management of chronic hepatitis B: A concise overview
Arno Furquim d'Almeida  1   2 , Erwin Ho  1   2 , Stijn Van Hees  1   2 , Thomas Vanwolleghem  1   2
Affiliations
Affiliations

    1
    Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium.
    2
    Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium.

    PMID: 34846093 DOI: 10.1002/ueg2.12176

Abstract

Worldwide, over 250 million people are chronically infected with the hepatitis B virus (HBV). Infected patients have an up to 100-fold increased risk for liver-related complications, including cirrhosis, hepatic decompensation and hepatocellular carcinoma. Nonetheless, the majority of the infections remains asymptomatic, stressing the importance of HBV screening and linkage to care. Excellent clinical outcomes are seen during nucleos(t)ide analogue (NA) therapy, which often is continued indefinitively due to a lack of functional cure. Increasing evidence suggests that NA discontinuation following long-term treatment induced viral suppression in patients without a functional cure may be a favourable option. Reliable biomarkers are, however, urgently needed to select the patients that would benefit from NA withdrawal. In addition, renewed and novel approaches to improve screening and linkage to care are other fundamental factors in the optimisation of the clinical management of chronic hepatitis B.

Keywords: chronic hepatitis B; clinical management; nucleos(t)ide analogues; screening; treatment discontinuation.

© 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.

StephenW

停止抗病毒治疗以实现功能性治愈或不需要药物治疗的非活动性疾病现在被认为是主流治疗。 但是，只有某些类型的患者应该停止。