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Current Therapy of Chronic Hepatitis B
国外的一篇文献,感觉还是挺有用的,我就把结论贴过来。附件是全文,想看的自己下载看看吧!版主觉得好的话帮忙置顶吧,谢谢啦!
Conclusions
If there are no contraindications, the treatment of choice for either HBeAg or anti-HBe chronic hepatitis B-naı¨ve patients is PEG-IFN alfa 2a or 2b administered for 48 weeks due to its higher response rate and sustained remission in comparison with nucleoside/nucleotide analogs (Table 1). Nucleoside/nucleotide analogs can be useful in naı¨ve patients when failure of PEG-IFN alfa therapy has been observed.
If there are contraindications to administer PEG-IFN alfa in naı¨ve patients, entecavir is the treatment of choice due to its similar antiviral efficacy in comparison with other analogues and its lack of appearance of resistant mutants and low secondary effects.
Due to the high frequency of appearance of resistant mutants with lamivudine, this drug should not be used in chronic hepatitis B treatment-naı¨ve patients (Table 2).
In patients under lamivudine treatment who develop resistant mutants, this drug should be maintained and adefovir should be added in order to achieve antiviral response.In the case of resistant mutant to adefovir or entecavir, tenofovir rescue therapy may be useful, although future studies with a large number of patients should be conducted.
In the future, the combination of PEG-IFN alfa with more than one nucleoside analog or triple combination of nucleoside analogues should be studied in resistant chronic hepatitis B.
[ 本帖最后由 旋干转坤 于 2009-12-16 13:49 编辑 ] |
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