HBV DNA阴性、HBsAg阳性的乙型肝炎肝硬化代偿期患者需要抗病毒治疗吗?

Do HBV DNA-negative HBsAg-positive patients with compensated hepatitis B cirrhosis need antiviral therapy?

HBV感染为我国肝病的常见病因,随着慢性乙型肝炎(CHB)抗病毒治疗相关研究的不断进展,抗病毒适应证也在不断扩大。然而,CHB患者抗病毒治疗的适应证仍存在很多争议,尤其对于HBV阴性的患者。本文通过对HBV DNA检测的局限性、HBV阴性CHB患者病毒再激活风险、DNA阴性的乙型肝炎肝硬化代偿期人群病情进展风险、抗病毒疗效及抗病毒治疗经济效益五方面进行分析,提出对HBV阴性、HBsAg阳性的乙型肝炎肝硬化代偿期患者抗病毒治疗的必要性。

Hepatitis B virus(HBV)infection is a common cause of liver disease in China,and with the continuous progress in the research on antiviral therapy for chronic hepatitis B,the indications for antiviral therapy are constantly expanding.However,there are still controversies over the indications for antiviral therapy in patients with chronic hepatitis B(CHB),especially those with negative HBV.By analyzing the limitations of HBV DNA detection,the risk of HBV reactivation in HBV-negative CHB patients,the risk of disease progression in the DNA-negative population with compensated hepatitis B cirrhosis,antiviral response,and the economic benefits of antiviral therapy,this article proposes the necessity of antiviral therapy for HBV-negative HBsAg-positive patients with compensated hepatitis B cirrhosis.