极低病毒血症:抗乙型肝炎病毒治疗过程中需要关注的临床新问题

Very low-level viremia:new clinical attention-requiring problem during the course of anti-hepatitis B virus treatment

临床研究证实慢性乙型肝炎患者接受核苷(酸)类似物抗病毒治疗过程中存在的低水平病毒血症与多种临床不良结局相关。随着PCR检测水平的提升,高灵敏度PCR技术的HBV DNA检测下限可达到<5~10 IU/ml。以HBV DNA < 20 IU/ml为判断标准获得完全病毒学应答者中,采用更高灵敏度PCR技术仍可发现部分患者存在极低水平的病毒血症(HBV DNA<20 IU/ml,但> 5~10 IU/ml)。长期存在的极低水平病毒血症是否影响慢性乙型肝炎患者的临床结局,目前相关研究较少,需要积累更多的研究数据回答这一临床问题。

Clinical studies have validated low-level viremia is associated with a variety of adverse outcomes in patients with chronic hepatitis B during the course of receiving nucleos(t)ide analogue antiviral therapy.With the advancement of PCR technology,the high sensitivity PCR detection of HBV DNA can reach the lower limit of detection of<5-10 IU/mL.The standard criterion for judging among patients who have achieved complete virological response is HBV DNA levels<20 IU/ml.The use of highly sensitive PCR tests can detect very low-level viremia(HBV DNA<20 IU/ml,but>5-10 IU/mL)in some patients.However,there are currently fewer relevant studies,and more research data needs to be accumulated to answer this clinical question of whether long-term very low-level viremia affects the clinical outcome of patients with chronic hepatitis B.