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慢性HBV感染免疫耐受期应否治疗?

庄辉

庄辉. 慢性HBV感染免疫耐受期应否治疗?[J]. 临床肝胆病杂志, 2021, 37(2): 272-277. DOI: 10.3969/j.issn.1001-5256.2021.02.007
引用本文: 庄辉. 慢性HBV感染免疫耐受期应否治疗?[J]. 临床肝胆病杂志, 2021, 37(2): 272-277. DOI: 10.3969/j.issn.1001-5256.2021.02.007
ZHUANG H. Should patients in the immune tolerance stage of chronic hepatitis B virus infection be treated?[J]. J Clin Hepatol, 2021, 37(2): 272-277. DOI: 10.3969/j.issn.1001-5256.2021.02.007
Citation: ZHUANG H. Should patients in the immune tolerance stage of chronic hepatitis B virus infection be treated?[J]. J Clin Hepatol, 2021, 37(2): 272-277. DOI: 10.3969/j.issn.1001-5256.2021.02.007

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

    通讯作者:

    庄辉,zhuangbmu@126.com

  • 针对这一热点难点问题,《临床肝胆病杂志》特设"学术争鸣"栏目,并邀请庄辉教授撰文与大家一起讨论,作为开始,不是定论。 本刊热忱欢迎广大读者就此议题踊跃参与讨论,来稿将陆续刊发。
  • 慢性HBV感染免疫耐受期患者是否应该接受治疗是目前国内外学术界争议较大、关注度很高的一个问题。 美国、欧洲及亚太指南一般不推荐对免疫耐受期慢性乙型肝炎予以治疗,但有多位学者建议对HBV感染免疫耐受期患者进行抗病毒治疗。
  • 今后,本刊将"学术争鸣"设为长期固定栏目,以问题为导向,提倡学术公正、公平,百家争鸣,百花齐放,在秉持学术民主的思辨中探索真理,为推动本学科学术争鸣尽应有职责。
  • 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
    下载: 导出CSV
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