摘要
乙型肝炎病毒(hepatitis B virus,HBV)感染呈世界性流行,是导致肝衰竭、肝硬化和肝细胞癌(hepatocellular carcinoma,HCC)等终末期肝病发生的重要原因。及时有效地抗病毒治疗可改善慢性乙型病毒性肝炎(chronic hepatitis B,CHB)患者的临床结局。HBV DNA是目前应用最广泛的抗病毒疗效评价指标,国内外指南将实现完全病毒学应答(complete virological response,CVR)作为CHB的基本治疗终点。然而在临床实践中发现,即使是服用强效的一线核苷(酸)类似物,仍有20%~30%的CHB患者不能获得或者不能长期维持CVR。研究表明,血清HBV DNA的持续或间断存在是慢性肝炎向肝硬化和肝癌等终末期肝病进展的重要危险因素。不同病毒学应答模式与CHB相关性终末期肝病的发生风险高低密切相关,因此了解CHB患者不同病毒学应答的临床结局具有重要意义。
Hepatitis B virus(HBV)infection is worldwide epidemie,which is an important cause of end-stage liver diseases,such as liver failure,eirhosis and heatoellular earcinomu(HCC).Timely and fective antivirl therapy ean improre the vlimioal outoome of shronie hepatie B(CHB)patiente.HBV DNA ie ourrentlyr the mort widely ueed indioator in.evaluaing the fficacy of antivirl therapy.Domestie and foreign guidelines regard comuplete virological response(CVR)as the basic endpoint of antiviral therapy.However,in clinical practice.it has been found.that approximately 20%to 30%of CHB patients cannot obtain or maintain CVR for a lonp time even if they are treated with highly ffeetive first-line anti-HBV drugs.Sudies have shown that the continwous or itermittent presence of serum HBV DNA is an important risk factor for the progression of chronic hepatitis to cirhosis,HCC and other end-stage liver diseases.Different virological response modes are closely related to the risk of hepatitis B-related end-stage liver disease.so it is important to understand the elinical outcomes of diferent virological responses in CHB patients.
作者
李兰清
周静
陈恩强
LI Lan-qing;ZHOU Jing;CHEN En-qiang(Center of Infectious Diseases,West China Haspital,Sichuan Unirersity,Chengdu 610041,China)
出处
《中国实用内科杂志》
CSCD
北大核心
2023年第5期355-359,共5页
Chinese Journal of Practical Internal Medicine
基金
四川大学华西医院临床研究孵化项目(2022HXFH013)。
关键词
慢性乙型病毒性肝炎
病毒学应答
肝硬化
肝细胞癌
chronie heputitis B
virological response
hepatic irrhosis
hepatocellular earcinoma
作者简介
通信作者:陈恩强,电子信箱:chenenqiang1983@hotmail.com。
