《2023年欧洲肝病学会临床实践指南:丁型肝炎病毒》意见要点
DOI: 10.3969/j.issn.1001-5256.2023.11.007
Key points of EASL Clinical Practice Guidelines on hepatitis delta virus (2023)
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摘要: 由于丁型肝炎病毒(HDV)诊断和治疗的重大创新,促使了欧洲肝病学会(EASL)于2023年7月发表了首个关于HDV感染者管理的国际临床实践指南。该指南主要围绕HDV的筛查、诊断、疾病的临床特征和影响因素、患者监测和治疗的选择、治疗方法以及治疗终点6个方面展开。通过对覆盖这6个方面的13个问题进行回答阐述,提出了相关的推荐意见。此外,该指南还对HDV的未来治疗进行了展望。笔者团队对该指南进行摘译,系统地介绍了推荐意见中的各类评估要点以及临床管理的相关建议,以促进我国对HDV感染者临床管理和决策制定的发展。Abstract: Due to significant innovations in the diagnosis and treatment of hepatitis D virus (HDV), the European Society of Hepatology (EASL) published its first international clinical practice guidelines on the management of individuals with HDV infection in July 2023. The guidelines mainly focus on the six aspects of HDV screening, diagnosis, clinical features and influencing factors, patient monitoring and selection for treatment, therapeutic methods and treatment endpoints. The guidelines give recommendations by answering and elaborating on 13 questions covering these six aspects. In addition, the guidelines also provide the prospect of the future treatment of HDV. The author’s team makes an excerpt of the guidelines and systematically introduces various evaluation points in recommendations and clinical management suggestions, in order to promote the development of clinical management and decision-making for individuals with HDV infection in China.
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Key words:
- Hepatitis Delta Virus /
- Hepatitis D, Chronic /
- Europe /
- Practice Guideline
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表 1 基于牛津循证医学中心的证据分级(改编自牛津2011年证据分级)
Table 1. Level of evidence based on the Oxford Centre for Evidence-based Medicine (adapted from The Oxford 2011 Levels of Evidence)
证据级别 标准描述 高、中、低证据的说明 1 随机对照试验的系统评价(同质性) 进一步研究不太可能改变预估 2 具有显著效果的随机对照试验或观察性研究;低质量研究的系统评价(即非随机、回顾性) 3 非随机对照队列研究/随访研究/随机对照组试验(系统评价通常优于单个研究) 进一步研究可能会改变预估 4 病例系列研究、病例对照研究或历史对照研究(系统评价通常优于单个研究) 5 专家意见(基于机制的推理) 不确定 表 2 推荐等级
Table 2. Grades of recommendation
推荐级别 描述 标准 强(A) 推荐;不推荐 证据、研究一致性、风险-获益比、患者偏好、伦理义务、可行性 弱或开放(B) 可能建议;可能不建议 -
[1] European Association for the Study of the Liver. EASL clinical practice guidelines on hepatitis delta virus[J]. J Hepatol, 2023, 79( 2): 433- 460. DOI: 10.1016/j.jhep.2023.05.001.