AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif F-94800, France.
Clin Liver Dis. 2013 Aug;17(3):451-73. doi: 10.1016/j.cld.2013.05.003. Epub 2013 Jun 27.
Antiviral therapy using newer nucleos(t)ide analogs with lower resistance rates could suppress hepatitis B virus (HBV) replication, improve liver function in patients with compensated or decompensated cirrhosis, delay or obviate liver transplantation in some patients, and reduce the risk of HBV recurrence. Some form of HBV prophylaxis needs to be continued indefinitely posttransplant. However, in patients with a low-risk of HBV recurrence it is possible to discontinue hepatitis B immunoglobulins and maintain long-term nucleos(t)ide analog therapy. Currently, treatment of posttransplantation hepatitis B is a less important clinical problem than it was historically because effective antiviral therapies exist to rescue patients who failed initial prophylaxis.
使用耐药率更低的新型核苷(酸)类似物进行抗病毒治疗,可以抑制乙型肝炎病毒(HBV)复制,改善代偿期或失代偿期肝硬化患者的肝功能,在某些患者中延迟或避免肝移植,并降低 HBV 复发的风险。移植后需要无限期地继续某种形式的 HBV 预防。然而,对于 HBV 复发风险低的患者,可以停用乙型肝炎免疫球蛋白并维持长期核苷(酸)类似物治疗。目前,与历史上相比,移植后乙型肝炎的治疗不再是一个重要的临床问题,因为存在有效的抗病毒治疗方法可以挽救初始预防失败的患者。