Peck-Radosavljevic Markus, Deutsch Johann, Ferenci Peter, Graziadei Ivo, Hofer Harald, Holzmann Heidemarie, Huber Wolf-Dietrich, Laferl Herman, Maieron Andreas, Stauber Rudolf, Vogel Wolfgang
Osterreichische Gesellschaft für Gastroenterologie und Hepatologie, Arbeitsgruppe Leber, Wien, Austria.
Wien Klin Wochenschr. 2010 May;122(9-10):280-302. doi: 10.1007/s00508-009-1298-0. Epub 2010 May 4.
Hepatitis B is the most common chronic viral infection of the liver. Chronic hepatitis B is estimated to affect at least 350 million people worldwide and is the leading cause of death from liver disease. There have been dramatic developments both in the diagnostic field and in drug treatment of chronic hepatitis B. Today, chronic hepatitis B is a well manageable disease in the vast majority of cases and the main challenge remains the detection of affected patients at an early enough disease stage to prevent end-stage liver disease and its complications. The rapid pace of drug development mandated an update of the Austrian guidelines on the treatment of hepatitis B, which after 1994 and 1998 were now dating back to 2005 in their third version. All chapters from the 3. consensus statement from 2005 were renewed except for the chapter on liver biopsy, which is still valid in its 2005-version. In particular, virologic parameters take now center stage for treatment decisions, HBV-genotyping is now being considered for the choice of treatment, and the oral first line treatment for chronic hepatitis B has been changed. Overall this consensus statement accounts for the major advances in the management of hepatitis B and significantly changes clinical management of patients with hepatitis B in Austria.
乙型肝炎是最常见的慢性肝脏病毒感染。据估计,全球至少有3.5亿人受到慢性乙型肝炎的影响,它是肝病致死的主要原因。在慢性乙型肝炎的诊断领域和药物治疗方面都取得了显著进展。如今,在绝大多数情况下,慢性乙型肝炎是一种易于管理的疾病,主要挑战仍然是在疾病早期阶段检测出受影响的患者,以预防终末期肝病及其并发症。药物研发的快速发展要求更新奥地利关于乙型肝炎治疗的指南,该指南在1994年和1998年之后,其第三版现已追溯到2005年。2005年第三次共识声明的所有章节都进行了更新,但关于肝活检的章节除外,该章节仍沿用其2005年版本。特别是,病毒学参数现在在治疗决策中占据核心地位,现在在选择治疗方法时会考虑进行乙肝病毒基因分型,并且慢性乙型肝炎的口服一线治疗方法已经改变。总体而言,本共识声明阐述了乙型肝炎管理方面的主要进展,并显著改变了奥地利乙型肝炎患者的临床管理。