慢性乙型肝炎:从"只治"到"全治"
Chronic hepatitis B:from"treat only if"to"treat all"
庄辉1
作者信息
- 1. 北京大学医学部基础医学院病原生物学系暨感染病中心,北京 100191
- 折叠
摘要
以往慢性乙型肝炎的治疗标准是基于发生合并症的风险,国际指南建议只治疗发生合并症风险高的患者,称之为"只治"("treat only if…")策略.后来发现,在发生肝细胞癌的病例中,33.5％～64.0％不符合国际指南的治疗标准,提示需要扩大慢性乙型肝炎的治疗标准.尔后,"只治"("treat only if…")策略被"全治但除外"("treat all except…")策略所替代.后者是慢性乙型肝炎全治,但除外发生合并症风险低的患者.在慢性乙型肝炎患者中,符合该策略治疗标准的比例由10.3％提高至26.5％～33.9％,但距世界卫生组织提出的80％治疗目标仍较远.因此,为及早达到2030年消除乙型肝炎的目标,提出了"全治"("treat all")策略,即对所有HBV DNA阳性的慢性乙型肝炎患者均治疗.
Abstract
The previous treatment criteria for chronic hepatitis B were based on the risk of complications occurring.International guidelines recommended treating only high-risk patients who developed complications,which was called the"treat only if…"strategy.Later,it was found that 33.5％～64.0％of the cases that developed hepatocellular carcinoma(HCC)did not meet the treatment criteria of international guidelines,suggesting that the treatment criteria for chronic hepatitis B need to be expanded.Following this,the"treat only if…"strategy was replaced by the"treat all except…"strategy.The latter is to treat all except patients at very low risk of complications.The proportion of patients with chronic hepatitis B who meet this strategy has risen from 10.3％to 26.5％～33.9％,but it is still far from the World Health Organization's proposed treatment target of 80％.Therefore,in an attempt to achieve the goal of eliminating hepatitis B by 2030,a"treat all"strategy has been proposed,wherein all chronic hepatitis B patients who test positive for HBV DNA should be treated as early as possible.
关键词
乙型肝炎/治疗/指南/消除/全治Key words
Hepatitis B/Therapeutic/Guideline/Elimination/Treat all引用本文复制引用
出版年
2024
NETL
NSTL
万方数据