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基于HBV DNA的治疗决定

Young-Suk Lim¹

¹Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Journal of viral hepatitis

|May 24, 2024

概括

慢性乙型肝炎病毒 (HBV) 感染的抗病毒治疗可以预防肝癌 (HCC). 治疗决策应优先考虑HBV DNA水平和年龄,而不是ALT水平,以减少CHB患者的HCC风险.

科学领域:

肝病学肝病学是一种肝病学.
病毒学病毒学
在瘤学瘤学.

背景情况:

慢性乙型肝炎病毒 (HBV) 感染是全球肝细胞癌 (HCC) 的主要原因之一.
抗病毒疗法抑制HBV复制,降低HCC风险和死亡率,但全球治疗率仍然很低 (2019年为2.2%).
目前的指导方针往往根据氨酸胺转移酶 (ALT) 水平或肝活检做出治疗决定,这可能会延迟治疗.

研究的目的:

审查证据,将血清HBVDNA水平与慢性乙型肝炎 (CHB) 患者的HCC风险联系起来.
倡导基于HBVDNA水平和患者年龄的修订治疗策略.
评估早期启动抗病毒治疗的影响和成本效益.

主要方法:

对有关HBVDNA水平,HCC风险和抗病毒治疗结果的现有文献进行系统审查.
分析HBVDNA与HCC风险之间的非线性抛物线关联.
收集有关早期治疗潜在影响和成本效益的数据.

主要成果:

血清HBVDNA水平与治疗和未治疗的CHB患者的HCC风险有显著的相关性.
这种关联遵循非线性抛物线模式,独立于HBeAg状态或ALT水平.
有证据表明,根据HBVDNA水平和年龄,早期启动治疗是有益的.

结论:

对CHB的抗病毒治疗决策应优先考虑血清HBVDNA水平和年龄,而不仅仅是ALT水平或肝活检.
基于病毒载量的积极治疗方法可以显著降低HCC发病率.
早期干预对于减轻HCC风险和改善CHB患者的治疗结果至关重要.

关键词:

灰色区域是一个灰色区域.乙型肝炎病毒的感染.肝细胞癌是肝细胞癌.一个不确定的阶段.肝癌肝癌是一种肝癌.

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