Zhong-Ming Tan, Bei-Cheng Sun, Liver Transplantation Center of the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
World J Gastroenterol. 2013 Dec 21;19(47):8895-901. doi: 10.3748/wjg.v19.i47.8895.
Chronic hepatitis B virus (HBV) infection is the key driving force of liver disease progression, resulting in the development of hepatic dysfunction, cirrhosis and hepatocellular carcinoma (HCC). The primary aim of therapy is to suppress or eliminate HBV replication to reduce the activity of hepatitis, thus reducing the risk of, or slowing the progression of, liver disease. Nucleos(t)ide analogues (Nucs) may result in rapid suppression of HBV replication with normalization of serum transaminases and restore liver function, thus increasing survival in patients with hepatic decompensation. Long-term Nuc therapy may result in histological improvement or reversal of advanced fibrosis and reduction in disease progression, including the development of HCC. The long-term benefits of a finite course of interferon (IFN)-α therapy also include a sustained and cumulative response, as well as hepatitis B surface antigen seroclearance and reduction in the development of cirrhosis and/or HCC. Pegylated IFN and newer Nucs may achieve better long-term outcomes because of improved efficacy and a low risk of drug resistance. However, treatment outcomes are still far from satisfactory. Understanding the effects of anti-HBV treatment against HCC incidence and recurrence after hepatectomy or liver transplantation is required for further improvement of outcome.
慢性乙型肝炎病毒（HBV）感染是肝脏疾病进展的关键驱动力，导致肝功能障碍、肝硬化和肝细胞癌（HCC）的发展。治疗的主要目的是抑制或消除 HBV 复制，以降低肝炎活动度，从而降低肝脏疾病的风险或减缓其进展。核苷（酸）类似物（Nucs）可迅速抑制 HBV 复制，使血清转氨酶正常化并恢复肝功能，从而提高肝功能失代偿患者的生存率。长期 Nuc 治疗可能导致组织学改善或逆转晚期纤维化，并减少疾病进展，包括 HCC 的发生。有限疗程干扰素（IFN）-α治疗的长期益处还包括持续和累积应答，以及乙型肝炎表面抗原血清学清除以及肝硬化和/或 HCC 发生的减少。聚乙二醇干扰素和新型 Nucs 可能由于疗效提高和耐药风险低而获得更好的长期结果。然而，治疗结果仍远不理想。为了进一步改善治疗效果，需要了解抗 HBV 治疗对肝切除或肝移植后 HCC 发生率和复发的影响。
