慢性乙型肝炎抗病毒治疗终点标志物研究进展

Research progress of antiviral end-point markers in chronic hepatitis B.

对慢性乙型肝炎病毒(HBV)感染进行规范的抗病毒治疗以阻断疾病进展,减少终末期肝病的发生至关重要。核苷(酸)类药物(NAs)被广泛应用于慢性乙肝(CHB)患者的抗病毒治疗,由于难以清除肝组织内的共价闭合环状DNA(cccDNA)从而治愈乙肝,现有指南均推荐对患者进行1~3年不等的巩固治疗或长期治疗。然而,长期治疗又给患者带来经济、社会和心理上的压力。如何确定这些患者的治疗终点以及部分患者是否可以安全停药,是极具争议的临床问题。目前针对CHB的抗病毒治疗亟需解决的问题:寻找能够真实反映cccDNA的存在及活性,用于NAs药物治疗评价患者病毒学治疗终点的血清学标志物,为接受NAs治疗的CHB患者提供个体化的停药风险指导。

It is very important to treat chronic hepatitis B virus(HBV)infection with standardized antiviral therapy in order to block the progress of disease and reduce the incidence of end-stage liver disease.Nucleos(t)ide drugs are widely used in the antiviral treatment for chronic hepatitis B(CHB).Because it is difficult to clear the cccDNA in the liver tissue to cure hepatitis B,the existing guidelines recommend consolidation treatment or long-term treatment for patients ranging from 1 to 3 years.However,long-term treatment brings economic,social and psychological pressure to patients.Determining the treatment end point of these patients and stopping medication safely in some patients is a highly controversial clinical issue.At present,there are some urgent problems to be solved in antiviral treatment for CHB:to find out the indicators that can truly reflect the existence and activity of cccDNA,to evaluate the end-point of virology treatment in patients with NAs,and to provide individualized guidance for CHB patients receiving NAS treatment.