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年龄>30岁、ALT水平正常HBV感染孕妇的抗病毒治疗时机

盛秋菊 汪玉涵 丁洋

引用本文:
Citation:

年龄>30岁、ALT水平正常HBV感染孕妇的抗病毒治疗时机

DOI: 10.12449/JCH240503
基金项目: 

辽宁省科技厅应用基础研究计划 (2022JH2/101500009)

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:盛秋菊负责撰写修改文章;汪玉涵负责查阅文献;丁洋负责拟定文章思路并最后定稿。
详细信息
    通信作者:

    丁洋, yding0903@sina.com (ORCID: 0000-0003-0836-7790)

Timing of antiviral therapy for pregnant women with HBV infection and normal alanine aminotransferase level aged >30 years

Research funding: 

Applied Basic Research Program of Liaoning Science and Technology Department (2022JH2/101500009)

More Information
    Corresponding author: Ding Yang, yding0903@sina.com (ORCID: 0000-0003-0836-7790)
  • 摘要: 《慢性乙型肝炎防治指南(2022版)》扩大了慢性乙型肝炎患者抗病毒治疗适应证。ALT水平正常的慢性HBV感染者,HBV DNA阳性,年龄>30岁,指南建议开始抗病毒治疗。但对于年龄>30岁的孕妇,是否立即启动抗病毒治疗尚无统一观点。有观点认为,ALT水平正常的孕妇多为免疫耐受期,抗病毒治疗效果不佳,且孕期用药可能影响母婴安全。因此,即使孕妇年龄>30岁,也不主张在孕早期开始抗病毒治疗;也有观点认为,孕期机体的免疫改变可能是HBV免疫清除的特殊时期,若年龄>30岁,即使ALT水平正常,也应该立即抗病毒治疗,孕妇可能获得更好的病毒学甚至血清学应答。本文将针对上述问题,从孕期抗病毒治疗目的、治疗时机和停药时机等方面展开论述。

     

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  • 收稿日期:  2024-02-29
  • 录用日期:  2024-04-07
  • 出版日期:  2024-05-25
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