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慢性HBV感染免疫耐受期应否治疗?

庄辉

引用本文:
Citation:

慢性HBV感染免疫耐受期应否治疗?

DOI: 10.3969/j.issn.1001-5256.2021.02.007
详细信息
    作者简介:

    庄辉,教授,中国工程院院士,主要从事病毒性肝炎研究

    通信作者:

    庄辉,zhuangbmu@126.com

  • 中图分类号: R512.62

Should patients in the immune tolerance stage of chronic hepatitis B virus infection be treated?

  • 摘要: 国际主要指南对慢性HBV感染免疫耐受期的定义不完全一致,但几乎所有指南均不推荐对免疫耐受期慢性乙型肝炎患者启动治疗。本文讨论了关于对HBV感染免疫耐受期患者进行抗病毒治疗的最新证据,以预防其肝硬化和肝细胞癌的发生。

     

  • 图  1  我国1990年—2014年161个疾病监测点城乡男女HCC年龄死亡专率[36]

    图  2  韩国多中心IT-CHB患者抗病毒治疗回顾性分析HCC及肝硬化累积发生率[48]

    表  1  ALT持续正常的IT-CHB患者有明显肝细胞炎症坏死和肝纤维化病理学改变

    作者 发表年份 总例数 有明显组织学病变例数 百分比(%)
    中国香港Wang等[38] 2005 14 6 42.9
    法国Andreani等[9] 2007 40 2 5.0
    美国Lai等[39] 2007 59 22 37.3
    韩国Park等[40] 2008 36 10 27.8
    印度Kumar等[41] 2008 73 29 39.7
    美国Nguyen等[42] 2009 41 13 31.7
    中国香港Seto等[43] 2012 40 7 17.5
    中国广州Liao等[44] 2013 85 42 49.4
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  • 收稿日期:  2021-01-08
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