在HBeAg阴性慢性乙型肝炎的功能治愈的有限核同类疗法:范式转变的最新发展
Yun-Fan Liaw1, George Papatheodoridis2
1Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Hepatology (Baltimore, Md.)
|September 24, 2024
概括
有限核酸类比 (Nuc) 疗法为慢性乙型肝炎 (CHB) 患者实现功能治愈提供了一种可行的策略,在停止治疗后,HBsAg损失率增加和肝病进展减少.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 胃肠病学 胃肠病学
背景情况:
- 长期的核胺类同类 (Nuc) 治疗抑制乙型肝炎病毒 (HBV),但很少达到HBsAg损失,这是功能治愈的标志.
- 不确定的Nuc疗法带来了挑战,包括成本,坚持和潜在的不良结果.
- 现在的指导方针有条件地支持对HBeAg阴性CHB患者的有限Nuc疗法.
研究的目的:
- 评估有限Nuc治疗慢性乙型肝炎 (CHB) 的可行性和安全性.
- 在CHB患者中,评估Nuc停止后的长期结果,包括HBsAg损失和肝病进展.
主要方法:
- 关于停止Nuc治疗的亚太地区,美国和欧洲指导方针的审查.
- 在HBeAg阴性CHB患者中研究有限Nuc治疗策略的研究分析.
- 对结局的检查,包括HBsAg损失率和肝病发病率,在停止Nuc治疗的患者与继续治疗的患者之间.
主要成果:
- 在多项研究中,Finite Nuc疗法被发现是可行的,并且相当安全.
- 在Nuc停止后随着长时间的随访,HBsAg损失率增加,特别是在高加索和亚洲患者中.
- 在HBV肝硬化患者的一项大型研究显示,与继续治疗相比,在Nuc停止后,HBsAg损失率显著上升,肝细胞癌和肝脏相关死亡率降低.
结论:
- 终极Nuc疗法是目前实现HBeAg阴性CHB.CHB功能治愈的最现实的策略.
- 在实现持续的HBV DNA不可检测性后停止Nuc治疗是一种可行的选择,提供潜在的长期益处.
- 需要对功能治疗的新型疗法进行进一步的研究,但有限的Nuc疗法今天提供了一种实际的方法.
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