2013年更新的NICE《儿童、青年和成人慢性乙型肝炎诊断和管理指南》解读

Explanation of the guideline on diagnosis and management of chronic hepatitis B in children,young people and adults updated by NICE in 2013

2013年6月,英国国立优质卫生和保健研究所（National Institute for Health and Care Excellence,NICE）发布更新的《儿童、青年和成人慢性乙型肝炎诊断和管理指南》[1]。NICE是非政府的公共卫生机构,为英格兰和威尔士医疗系统服务,其前身为1999年成立的国立临床优质研究所（National Institute for Clinical Excellence,NICE）。2005年4月与该所卫生发展所合并为新的国立优质卫生和临床研究所（National Institute for Health and Clinical Excellence）,仍简称为NICE。

The guideline on diagnosis and management of chronic hepatitis B in children, young people and adults issued by the National Institute for Health and Care Excellence （NICE） , the United Kingdom in June 2013 updates and replaces recommendations in NICE technology appraisal 96 and incorporates recommenda- tions from NICE technology appraisals 96, 153, 154 and 173. This guideline covers the following： informa- tion needs of people with chronic hepatitis 13 and their caters; where children, young people and adults with chronic hepatitis B should be assessed; assessment of liver disease, including the use of non-invasive tests and genotype testing; criteria for offering antiviral treatment; the efficacy, safety and cost; effectiveness of cur- rently available treatments; selection of first line therapy; management of treatment failure or drug resistance; whether there is a role for combination therapy; when it is possible to stop treatment; managing the care of pregnant and breastfeeding women and prevention of vertical transmission; prophylactic treatment during im- munosuppressive therapy; monitoring for treatment response, severity of fibrosis and development of HCC.