慢性乙型肝炎抗病毒用药临床要点

Clinical highlight of anti-virus medicine on type B hepatitis

对慢性乙型肝炎患者来说,干扰素α仍然是抗乙型肝炎病毒(HBV)的主要药物,但使用不方便、不良反应较大,不宜用于失代偿期肝硬化患者。而所有已经上市的以及正处于研发或临床试验阶段的核苷(酸)类似物抗病毒制剂均是以持续抑制病毒复制发挥其抗病毒作用,还难以达到彻底清除病毒,需要长期治疗达到最大限度地抑制HBV复制。联合用药目前处于探索研究中。医生需要根据病毒的特点、患者的个体对抗HBV治疗的应答、耐受性以及心理健康等拟定出更科学的个体化抗病毒治疗方案。

Summary：For the patients with chronic type-B hepatitis, interferon-α is still the main anti-viral medicine, but it cannot be used in hepatic cirrhosis patients during decompensative period. All commercially available ribonucleoside analogs or trialdrugs can only persistently inhibit virus replication, but not thoroughly clear virus, and have to be used for long-time. The combined therapy is still on study. The physicians should make scientific and individualized antiviral therapeutic regimen according to virus characteristics, the patient＇s response to anti-HBV therapy, tolerance and psychological health.