BMJ:慢性乙型肝炎感染的管理

2015-10-25 zhaoshuang 译 MedSci原创

AA

乙型肝炎病毒(HBV)感染是一个全球性的健康问题,可导致肝硬化和肝癌(HCC)。虽然接种乙型肝炎病毒疫苗可降低乙型肝炎病毒感染的患病率,但该疾病的负担仍然很高。


抗病毒药物治疗可以降低肝损的风险并延缓其向肝癌演变,甚至可以逆转肝纤维化。然而,治疗时最大的挑战在于选择治疗时间、治疗方式和治疗周期。

目前批准的治疗乙型肝炎的药物包括聚乙二醇干扰素和核苷类似物。核苷类似物具有更好的耐受性,抗病毒能力强且不容易产生耐药性,但聚乙二醇干扰素疗程更合适。

监测乙肝表面抗原(HBsAg)水平可能有助于预测治疗过程中可能出现的各种反应的,特别是聚乙二醇干扰素。长期治疗通常还需要用口服抗病毒药物,如果停止治疗则容易复发。因此有必要寻找新疗法间断清除HBV DNA和HBsAg。

原始出处:

K Kowdley.Management of chronic hepatitis B infection.BMJ.Oct 21,2015

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  1. 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  2. 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topicName=慢性乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Tue Oct 27 11:15:00 CST 2015, time=2015-10-27, status=1, ipAttribution=)]
    2016-04-29 707986060

    真的是文题不符。

    0

  3. 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topicName=慢性乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Tue Oct 27 11:15:00 CST 2015, time=2015-10-27, status=1, ipAttribution=)]
    2016-04-29 707986060

    不好

    0

  4. 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createdTime=Mon Dec 28 06:27:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42772, encodeId=c51c42e7220, content=通篇看完,感觉有些么名奇妙,没一点具体实用的内容!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:47:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42771, encodeId=bc8e42e7161, content=表面抗原如何监测, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:46:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42770, encodeId=91b342e709e, content=治疗时最大的挑战在于选择治疗时间、治疗方式和治疗周期。具体内容。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:45:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1271237, encodeId=358b12e1237be, content=<a href='/topic/show?id=3d745346316' target=_blank style='color:#2F92EE;'>#慢性乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53463, encryptionId=3d745346316, topicName=慢性乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Tue Oct 27 11:15:00 CST 2015, time=2015-10-27, status=1, ipAttribution=)]
    2016-02-04 gaoxiaoe
  5. [GetPortalCommentsPageByObjectIdResponse(id=1825597, encodeId=4419182559ef9, content=<a href='/topic/show?id=1a942339426' target=_blank style='color:#2F92EE;'>#乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23394, encryptionId=1a942339426, topicName=乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ea6321, createdName=okhuali, createdTime=Sun Jan 31 06:15:00 CST 2016, time=2016-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83248, encodeId=53ce83248a5, content=真的是文题不符。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b011604242, createdName=707986060, createdTime=Fri Apr 29 01:13:00 CST 2016, time=2016-04-29, status=1, ipAttribution=), 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createdTime=Mon Dec 28 06:27:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42772, encodeId=c51c42e7220, content=通篇看完,感觉有些么名奇妙,没一点具体实用的内容!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:47:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42771, encodeId=bc8e42e7161, content=表面抗原如何监测, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:46:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42770, encodeId=91b342e709e, content=治疗时最大的挑战在于选择治疗时间、治疗方式和治疗周期。具体内容。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:45:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1271237, encodeId=358b12e1237be, content=<a href='/topic/show?id=3d745346316' target=_blank style='color:#2F92EE;'>#慢性乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53463, encryptionId=3d745346316, topicName=慢性乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Tue Oct 27 11:15:00 CST 2015, time=2015-10-27, status=1, ipAttribution=)]
    2015-12-28 wzf990214

    不错哦

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1825597, encodeId=4419182559ef9, content=<a href='/topic/show?id=1a942339426' target=_blank style='color:#2F92EE;'>#乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23394, encryptionId=1a942339426, topicName=乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ea6321, createdName=okhuali, createdTime=Sun Jan 31 06:15:00 CST 2016, time=2016-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83248, encodeId=53ce83248a5, content=真的是文题不符。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b011604242, createdName=707986060, createdTime=Fri Apr 29 01:13:00 CST 2016, time=2016-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83249, encodeId=81d98324977, content=不好, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b011604242, createdName=707986060, createdTime=Fri Apr 29 01:13:00 CST 2016, time=2016-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847733, encodeId=1c56184e73365, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Feb 04 18:15:00 CST 2016, time=2016-02-04, status=1, ipAttribution=), 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createdTime=Mon Dec 28 06:27:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42772, encodeId=c51c42e7220, content=通篇看完,感觉有些么名奇妙,没一点具体实用的内容!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:47:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42771, encodeId=bc8e42e7161, content=表面抗原如何监测, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:46:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42770, encodeId=91b342e709e, content=治疗时最大的挑战在于选择治疗时间、治疗方式和治疗周期。具体内容。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:45:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1271237, encodeId=358b12e1237be, content=<a href='/topic/show?id=3d745346316' target=_blank style='color:#2F92EE;'>#慢性乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53463, encryptionId=3d745346316, topicName=慢性乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Tue Oct 27 11:15:00 CST 2015, time=2015-10-27, status=1, ipAttribution=)]
    2015-12-28 wzf990214

    赞一个

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1825597, encodeId=4419182559ef9, content=<a href='/topic/show?id=1a942339426' target=_blank style='color:#2F92EE;'>#乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23394, encryptionId=1a942339426, topicName=乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ea6321, createdName=okhuali, createdTime=Sun Jan 31 06:15:00 CST 2016, time=2016-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83248, encodeId=53ce83248a5, content=真的是文题不符。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b011604242, createdName=707986060, createdTime=Fri Apr 29 01:13:00 CST 2016, time=2016-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83249, encodeId=81d98324977, content=不好, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b011604242, createdName=707986060, createdTime=Fri Apr 29 01:13:00 CST 2016, time=2016-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847733, encodeId=1c56184e73365, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Feb 04 18:15:00 CST 2016, time=2016-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49816, encodeId=ec7d49816c5, content=不错哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Dec 28 06:27:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49817, encodeId=71ad4981ec7, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Dec 28 06:27:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42772, encodeId=c51c42e7220, content=通篇看完,感觉有些么名奇妙,没一点具体实用的内容!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:47:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42771, encodeId=bc8e42e7161, content=表面抗原如何监测, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:46:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42770, encodeId=91b342e709e, content=治疗时最大的挑战在于选择治疗时间、治疗方式和治疗周期。具体内容。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:45:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1271237, encodeId=358b12e1237be, content=<a href='/topic/show?id=3d745346316' target=_blank style='color:#2F92EE;'>#慢性乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53463, encryptionId=3d745346316, topicName=慢性乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Tue Oct 27 11:15:00 CST 2015, time=2015-10-27, status=1, ipAttribution=)]
    2015-11-07 xjbtdbs150wgf

    通篇看完,感觉有些么名奇妙,没一点具体实用的内容!

    0

  8. 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topicName=慢性乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Tue Oct 27 11:15:00 CST 2015, time=2015-10-27, status=1, ipAttribution=)]
    2015-11-07 xjbtdbs150wgf

    表面抗原如何监测

    0

  9. 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    2015-11-07 xjbtdbs150wgf

    治疗时最大的挑战在于选择治疗时间、治疗方式和治疗周期。具体内容。

    0

  10. 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