Division of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan.
Division of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan.
Clin Gastroenterol Hepatol. 2014 Jan;12(1):16-26. doi: 10.1016/j.cgh.2013.04.036. Epub 2013 May 6.
Seven drugs have been approved for the treatment of chronic hepatitis B. Antiviral treatment has been shown to be effective in suppressing hepatitis B virus replication, decreasing inflammation and fibrosis in the liver, and preventing progression of liver disease. However, current medications do not eradicate hepatitis B virus; therefore, a key question is which patients need to start treatment and which patients can be monitored. Professional societies have developed guidelines to assist physicians in recognition, diagnosis, and optimal management of patients with chronic hepatitis B. These guidelines suggest preferred approaches, and physicians are expected to exercise clinical judgment to determine the most appropriate management based on the circumstances of the individual patient. This article reviews recommendations in hepatitis B guidelines and the basis for those recommendations, and we discuss what we do in our practice to illustrate factors that may influence decisions regarding hepatitis B management.
七种药物已获准用于治疗慢性乙型肝炎。抗病毒治疗已被证明可有效抑制乙型肝炎病毒复制，减轻肝脏炎症和纤维化，防止肝病进展。然而，目前的药物并不能彻底清除乙型肝炎病毒；因此，一个关键问题是哪些患者需要开始治疗，哪些患者可以进行监测。专业协会制定了指南，以帮助医生识别、诊断和优化慢性乙型肝炎患者的管理。这些指南建议了首选方法，预计医生将根据患者的具体情况行使临床判断，以确定最合适的管理方法。本文综述了乙型肝炎指南中的推荐意见及其依据，并讨论了我们在实践中为说明可能影响乙型肝炎管理决策的因素而采取的措施。
