[不定期慢性乙型肝炎病毒感染者的诊断和治疗新进展]。

Q3 Medicine
J C Liu, C Wu, J Li
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引用次数: 0

摘要

国内外权威指南通常将慢性乙型肝炎病毒(HBV)感染分为四个阶段。但在临床实践中,有相当一部分患者并不符合分期指南的要求,被称为 "不定期 "慢性 HBV 感染者。研究表明,处于不确定期的患者约占慢性 HBV 感染者的 30%-50%,很大一部分患者的肝脏组织学发生了明显变化,甚至出现肝硬化,如果不接受抗病毒治疗,他们罹患 HCC 和死亡的风险较高。初步研究表明,处于不确定期的患者接受抗病毒治疗后,病毒学应答良好,HCC 风险显著降低。为此,2022 年出版的《关于扩大慢性乙型肝炎抗病毒治疗的专家意见》建议对随访一年以上的不确定期患者进行积极治疗。然而,目前仍缺乏统一的标准来细化分类,也缺乏有效、快速的无创诊断方法来识别有疾病进展风险的不确定期患者。本文旨在综述有关不确定期慢性 HBV 感染者的比例、临床特征、疾病进展和治疗效果的研究,以进一步探讨如何更好地管理不确定期慢性 HBV 感染者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[New progress on diagnosis and treatment for indeterminate-phase chronic hepatitis B virus-infected patients].

Authoritative guidelines at home and abroad typically classify chronic hepatitis B virus (HBV) infection into four stages. However, in clinical practice, a considerable number of patients do not meet the guidelines for staging and are called "indeterminate phase" chronic HBV- infected patients. Studies have shown that patients in the indeterminate phase account for about 30%-50% of chronic HBV infection, have significant liver histological changes or even cirrhosis in a large proportion, and are at a higher risk of HCC and death if they do not receive antiviral therapy. Preliminary research shows that patients in the indeterminate phase who receive antiviral treatment have a good virological response and a remarkable reduced HCC risk. To this end, the 2022 publication "Expert Opinions on Expanding Antiviral Treatment for Chronic Hepatitis B" recommends aggressive treatment for patients with an indeterminate phase who have undergone more than a year of follow-up. However, there is still a lack of unified standards to refine the classification, as well as a lack of effective and rapid non-invasive diagnostic methods to identify patients in the indeterminate phase who are at risk for disease progression. This article aims to review the researches on the proportion, clinical characteristics, disease progression, and treatment benefits to further explore how to better manage indeterminate-phase chronic HBV-infected patients.

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来源期刊
中华肝脏病杂志
中华肝脏病杂志 Medicine-Medicine (all)
CiteScore
1.20
自引率
0.00%
发文量
7574
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