慢性乙型肝炎的不确定阶段/灰色区域:临床特征,结果和分子见解
Maria Stella Franzè1,2,3, Teresa Pollicino3, Jean-Michel Pawlotsky1,2,4
1Team "Viruses, Hepatology, Cancer", Institut Mondor de Recherche Biomédicale, INSERM Unit U955, Créteil, France.
概括
慢性乙型肝炎病毒 (HBV) 感染对全球健康构成风险. 不确定或"灰色区域"的患者需要进一步研究最佳的抗病毒治疗策略和长期结果评估.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 公共卫生 公共卫生
背景情况:
- 慢性乙型肝炎病毒 (HBV) 感染是一个重大的全球健康问题,导致严重的肝病并发症,如肝硬化和肝细胞癌 (HCC).
- 目前的抗病毒疗法旨在预防疾病的进展和传播,但治疗率仍然低于最佳水平.
- 慢性HBV感染的自然史是动态的,很大一部分患者陷入"不确定的"或"灰色区域",这使治疗决策复杂化.
研究的目的:
- 审查目前关于慢性HBV感染在不确定阶段的临床特征,管理和结果的知识.
- 要突出在这个"灰色地带"中管理那些有疾病进展风险的患者的挑战,尽管他们没有满足当前的治疗标准.
- 讨论关于抗病毒疗法的潜在益处在选定的"灰色区域"患者和需要精细的管理策略的新兴数据.
主要方法:
- 对不确定阶段慢性HBV感染的临床特征,管理方法和结果的文献综述.
- 分析当前的国际指导方针,并转向个性化,基于风险的治疗决策.
- 对先前不符合条件的患者群体抗病毒疗法疗效的新兴数据的综合分析.
主要成果:
- 很大一部分慢性HBV患者 (28-55%) 不能完全适应确定的临床阶段,形成"灰色地带".
- 在"灰色区域"的患者有患肝纤维化,肝硬化和HCC的风险,但往往缺乏抗病毒治疗的明确迹象.
- 新出现的证据表明,在选定的"灰色地带"患者中,抗病毒疗法可能具有长期益处,尽管结果是可变的.
结论:
- 慢性HBV感染的"灰色区域"代表了一个异质的群体,需要进一步研究以优化管理.
- 个性化,基于风险的方法越来越重要,超越了严格的阶段分类.
- 进一步的研究对于完善治疗策略和评估抗病毒疗法的长期益处在这个具有挑战性的患者群体中至关重要.
相关概念视频
COPD: Pathogenesis and Clinical Features
1.9K
Chronic obstructive pulmonary disease (COPD) is a group of lung conditions that progressively worsen over time, including chronic bronchitis and emphysema. This cluster of diseases collectively leads to a gradual and irreversible decline in lung function over time.
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
1.9K
Hybrid Zones
22.0K
Hybrid zones are narrow regions where two closely related species interact, mate, and produce hybrids. Relative to either parent species, hybrids may possess distinct phenotypic or genetic differences that impact their survival and reproductive success. The genetic variances introduced by hybridization influence species diversity and speciation processes within the hybrid zone.
22.0K
Esophageal Strictures-II: Clinical Features and Management
694
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
694
Endocarditis II: Clinical Features of Infective Endocarditis
552
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
552
Pericarditis II: Clinical Features and Diagnostic Tests
344
Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
344
Myocarditis II: Clinical Features and Diagnostic Tests
334
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
334


