支持2025年AASLD慢性乙型肝炎管理实践指南的技术系统审查
Calvin Q Pan1, Samer Saadi2, Marc G Ghany3
1Division of Gastroenterology and Hepatology, Department of Medicine, NYU Langone Health, New York University Grossman School of Medicine, New York, NY, USA.
Hepatology (Baltimore, Md.)
|November 4, 2025
概括
本审查指导了2025年慢性乙型肝炎 (CHB) 管理指南. 它强调了治疗免疫耐受性CHB的不确定的益处,停止抗病毒治疗的潜在风险,以及需要量身定制的肝细胞癌 (HCC) 监测.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 临床实践指南 临床实践指南
背景情况:
- 慢性乙型肝炎 (CHB) 管理正在迅速发展.
- 本次审查解决了更新2025年AASLD实践指南的关键问题.
- 重点是为CHB护理提供基于证据的建议.
研究的目的:
- 为2025年AASLD关于CHB管理的实践指南提供基于证据的指导.
- 系统地审查与CHB治疗和监测有关的四个关键PICO问题.
- 在复杂的CHB场景中为临床决策提供信息.
主要方法:
- 一个遵循PRISMA指南的技术系统审查.
- 评估四个关于CHB管理的PICO问题.
- 对抗病毒治疗,停药和HCC监测策略的分析.
主要成果:
- 有限的证据表明,抗病毒疗法可能会降低HBV传播风险 (确定性低).
- 治疗免疫耐受性CHB的益处是不确定的 (确定性非常低).
- 停止治疗会增加HBsAg的损失,但存在复发的风险;对同时感染的患者,HCC监测是有益的.
结论:
- 在传染预防和免疫耐受性治疗阶段,支持共享决策.
- 在没有HBsAg损失的情况下停止抗病毒治疗时,建议谨慎.
- 建议针对患有同时感染或肝硬化的患者进行量身定制的HCC监测.
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