如何有效监测老年慢性乙型肝炎患者：综述

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如何有效监测老年慢性乙型肝炎患者：综述


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作者 Kang CK、Brennan PN、Dillon JF

2022 年 9 月 1 日收到

接受出版 2022 年 11 月 17 日

2022 年 12 月 9 日出版 2022 卷：17 页 1811—1820

DOI https://doi.org/10.2147/CIA.S366255

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批准出版的编辑：Maddalena Illario 博士
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陈吉康、保罗·布伦南、约翰·F·狄龙

分子与临床医学部，医学院，Ninewells 医院和医学院，邓迪大学邓迪，英国

通信：John F Dillon，电子邮件 [email protected]

摘要：乙型肝炎病毒 (HBV) 感染是一项重大的全球公共卫生挑战，具有显着的发病率和死亡率。 由于全球人口老龄化，老年人乙型肝炎病毒感染将越来越普遍。 存在有效的普遍疫苗接种计划，但这些计划主要针对年轻人口。 因此，老年人口仍然面临更高的疾病负担风险。 新诊断的老年人 HBV 感染通常是无症状的慢性感染，这会增加他们发展为肝硬化、肝细胞癌和与肝病相关的死亡率的风险，尤其是如果不及时治疗的话。 生理变化和与衰老相关的多种疾病患病率的增加也可能使慢性 HBV 感染的老年患者的预后恶化。 因此，应该密切有效地监测这组患者。 不幸的是，目前的国际临床实践指南并未提供针对慢性 HBV 感染的老年患者的硬性治疗终点。 这些患者的管理很复杂，需要个体化的方法。 需要考虑生理变化、合并症、依从性、治疗耐受性和疗效、治疗负担以及现实的治疗目标等多种因素。 患者和临床医生之间的共同决策对于确保支持或反对治疗的最终决定符合患者的价值观和偏好至关重要。 这篇综述文章旨在总结老年人群中慢性 HBV 感染的监测和管理。

Keywords: 慢性乙型肝炎, 老龄化, 老年人, 有效监测

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How to Effectively Monitor Aging Patients with Chronic Hepatitis B: A Review
      

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Authors Kang CK, Brennan PN , Dillon JF 

Received 1 September 2022

Accepted for publication 17 November 2022

Published 9 December 2022 Volume 2022:17 Pages 1811—1820

DOI https://doi.org/10.2147/CIA.S366255

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Editor who approved publication: Dr Maddalena Illario
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Chan Keat Kang, Paul N Brennan, John F Dillon

Division of Molecular and Clinical Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK

Correspondence: John F Dillon, Email [email protected]

Abstract: Hepatitis B virus (HBV) infection is a major global public health challenge associated with significant morbidity and mortality. Due to worldwide population aging, HBV infection in the elderly will become increasingly prevalent. Effective universal vaccination programs exist but these are largely targeted towards the younger population. Therefore, the elderly population remains at risk of higher disease burden. New diagnoses of HBV infection in the elderly are usually asymptomatic chronic infections which increases their risk of developing cirrhosis, hepatocellular carcinoma, and liver disease-related mortality, especially if left untreated. Physiological changes and the increasing prevalence of multimorbidity associated with aging also potentially worsen outcomes in elderly patients with chronic HBV infection. Therefore, this cohort of patients should be monitored closely and effectively. Current international clinical practice guidelines unfortunately do not provide hard treatment endpoints specific to elderly patients with chronic HBV infection. Management of these patients is complex and requires an individualized approach. Multiple factors such as physiological changes, comorbidities, compliance, treatment tolerability and efficacy, burden of treatment, and realistic treatment goals need to be considered. Shared decision-making between patient and clinician is essential to ensure that the final decision for or against treatment aligns with the patient’s values and preferences. This review article aims to summarize the monitoring and management of chronic HBV infection in the aging population.

Keywords: chronic hepatitis B, aging, elderly, effective monitoring

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