Department of Gastroenterology, the Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China.
Chin Med J (Engl). 2012 Jan;125(2):373-7.
To review the development, mechanism, necessity and limitation of antiviral therapy in decompensated hepatitis B virus-related cirrhosis.
Most information was pulled from a literature search (Pubmed 2000 to 2011) using the keywords of antiviral and decompensated hepatitis B virus-related cirrhosis. Relevant book chapters were also reviewed.
Well-controlled, prospective landmark studies and review articles on antiviral therapy in decompesated hepatitis B virus-related cirrhosis were selected.
Specific antiviral agents not only control viral replication, which permits liver transplantation, but also improve liver function so significantly that patients could be removed from the transplant waiting list. However, the emergence of drug-resistant mutants can result in treatment failure. Combination therapy is a save-strategy in drug-resistant.
Although the treatment of end-stage liver disease is still a challenge worldwide, antiviral therapy has altered the natural history of hepatitis B patients with decompensated cirrhosis. The approval of the new generation of antivirals is opening new perspectives for finding the optimal antiviral treatment for patients with decompensated cirrhosis and preventing antiviral resistance. A combination of antivirals may be one of the future strategies for fulfilling these goals.
综述失代偿乙型肝炎病毒相关性肝硬化抗病毒治疗的进展、机制、必要性和局限性。
主要信息来源于使用抗病毒和失代偿乙型肝炎病毒相关性肝硬化等关键词的文献检索（Pubmed 2000 至 2011 年）。还查阅了相关的书籍章节。
选择了关于失代偿乙型肝炎病毒相关性肝硬化抗病毒治疗的对照良好、前瞻性的标志性研究和综述文章。
特定的抗病毒药物不仅可以控制病毒复制，从而允许进行肝移植，而且还可以显著改善肝功能，使患者可以从移植等待名单中删除。然而，耐药突变体的出现可能导致治疗失败。联合治疗是耐药的一种挽救策略。
尽管全球范围内终末期肝病的治疗仍然是一个挑战，但抗病毒治疗改变了失代偿性肝硬化乙型肝炎患者的自然史。新一代抗病毒药物的批准为寻找失代偿性肝硬化患者的最佳抗病毒治疗方法和预防抗病毒耐药性开辟了新的前景。抗病毒药物联合治疗可能是实现这些目标的未来策略之一。
