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乙型肝炎病毒感染的灰色区域
1Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
概括
患有慢性乙型肝炎 (CHB) 的患者在"灰色区域"中,乙型肝炎病毒 (HBV) DNA 水平较高,面临重大风险. 建议对这些患者推简化治疗策略,不论其氨酸转移酶 (ALT) 水平如何.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 内部医学 内部医学
背景情况:
- 相当多的慢性乙型肝炎 (CHB) 患者属于不确定的或"灰色区域",缺乏明确的管理指南.
- 目前的临床实践指南为这种灰色区域人群的抗病毒治疗提供了有限的建议.
- 灰色区域的CHB患者肝炎B病毒 (HBV) DNA (>2000 IU/mL) 和正常的氨酸转移酶 (ALT) 水平升高,具有肝病进展的高风险.
研究的目的:
- 审查有关灰色区CHB患者的分子,临床和经济数据.
- 倡导在灰色区域为成年CHB患者简化治疗启动策略.
- 为了支持更广泛的抗病毒治疗启动CHB患者的HBVDNA≥2000 IU/mL,无论ALT水平.
主要方法:
- 对现有的分子,临床和经济数据进行全面审查.
- 分析与灰色区域CHB相关的风险因素.
- 评估当前治疗指南及其局限性.
主要成果:
- 灰色区域CHB患者的HBVDNA≥2000 IU/mL和正常的ALT具有肝炎,纤维化和肝细胞癌的高风险.
- 现有的数据支持该风险组的临床意义.
- 该审查强调需要更新治疗方案.
结论:
- 对于灰色区域的成年CHB患者,需要简化治疗启动策略.
- 在HBVDNA≥2000 IU/mL的患者中,即使ALT水平正常,也应考虑抗病毒治疗.
- 扩大治疗标准可以减轻与未经处理的灰色区域CHB相关的长期风险.
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