2025年慢性乙型肝炎:诊断,治疗和未来的方向
Andrew G Watson1, Akhilesh S Mulay1, Upkar S Gill1
1Centre for Immunobiology, Blizard Institute, Barts and the London Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK.
Clinical medicine (London, England)
|November 5, 2025
概括
针对慢性乙型肝炎 (CHB) 的新欧洲指南侧重于针对功能治愈 (HBsAg损失) 的个性化有限疗法的生物标志物. 这包括更新的诊断,治疗和监测策略,以更好地管理患者.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 临床医学 临床医学
背景情况:
- 慢性乙型肝炎 (CHB) 是肝硬化和肝细胞癌 (HCC) 的主要原因.
- 尽管有可用的治疗方法,但许多CHB患者未被诊断或治疗不足.
- 2025年欧洲肝脏研究协会 (EASL) 的指导方针引入了转向生物标志物主导,有限和个性化的治疗策略的范式转变.
研究的目的:
- 审查关于CHB管理的最新EASL指南.
- 概述诊断,分期,治疗开始/终止和监测的建议.
- 突出新生物标志物和代谢并发症在CHB管理中的作用.
主要方法:
- 对CHB的2025年EASL指南的审查.
- 关于血清学和病毒学标记的最新建议的总结.
- 包括有关新生物标志物 (定量HBsAg,HBcrAg,HBVRNA) 和代谢性并发症 (MASLD) 的信息.
主要成果:
- 更新的指导方针强调了以生物标志物为导向的疗法,以实现功能治愈 (持续的HBsAg损失).
- 新的生物标志物改善了疾病分层,指导治疗,并告知NA的停用.
- 像MASLD这样的代谢并发症被认为是加速纤维化和HCC风险的因素.
结论:
- 对HBV标志物和新生物标志物的准确解释对于个性化CHB治疗至关重要.
- 这些指导方针主张有限的治疗方案和功能性治疗.
- 新兴疗法和更新的监测策略为CHB患者提供了更好的结果.
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