《亚太地区慢性乙型肝炎管理共识声明:2012年更新版》
Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update.
作者信息
Liaw Yun-Fan, Kao Jia-Horng, Piratvisuth Teerha, Chan Henry Lik Yuen, Chien Rong-Nan, Liu Chun-Jen, Gane Ed, Locarnini Stephen, Lim Seng-Gee, Han Kwang-Hyub, Amarapurkar Deepak, Cooksley Graham, Jafri Wasim, Mohamed Rosmawati, Hou Jin-Lin, Chuang Wan-Long, Lesmana Laurentius A, Sollano Jose D, Suh Dong-Jin, Omata Masao
机构信息
Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 199, Tung Hwa North Road, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
出版信息
Hepatol Int. 2012 Jun;6(3):531-61. doi: 10.1007/s12072-012-9365-4. Epub 2012 May 17.
Large volume of new data on the natural history and treatment of chronic hepatitis B virus (HBV) infection have become available since 2008. These include further studies in asymptomatic subjects with chronic HBV infection and community-based cohorts, the role of HBV genotype/naturally occurring HBV mutations, the application of non-invasive assessment of hepatic fibrosis and quantitation of HBV surface antigen and new drug or new strategies towards more effective therapy. To update HBV management guidelines, relevant new data were reviewed and assessed by experts from the region, and the significance of the reported findings was discussed and debated. The earlier "Asian-Pacific consensus statement on the management of chronic hepatitis B" was revised accordingly. The key terms used in the statement were also defined. The new guidelines include general management, indications for fibrosis assessment, time to start or stop drug therapy, choice of drug to initiate therapy, when and how to monitor the patients during and after stopping drug therapy. Recommendations on the therapy of patients in special circumstances, including women in childbearing age, patients with antiviral drug resistance, concurrent viral infection, hepatic decompensation, patients receiving immune suppression or chemotherapy and patients in the setting of liver transplantation and hepatocellular carcinoma, are also included.
自2008年以来,已有大量关于慢性乙型肝炎病毒(HBV)感染自然史和治疗的新数据。这些数据包括对慢性HBV感染无症状受试者和社区队列的进一步研究、HBV基因型/自然发生的HBV突变的作用、肝纤维化无创评估以及HBV表面抗原定量的应用,以及更有效治疗的新药或新策略。为更新HBV管理指南,该地区的专家对相关新数据进行了审查和评估,并对报告结果的意义进行了讨论和辩论。早期的《亚太地区慢性乙型肝炎管理共识声明》据此进行了修订。声明中使用的关键术语也进行了定义。新指南包括一般管理、纤维化评估指征、开始或停止药物治疗的时机、起始治疗药物的选择、在停止药物治疗期间及之后何时以及如何监测患者。还包括了对特殊情况患者治疗的建议,包括育龄妇女、抗病毒药物耐药患者、合并病毒感染患者、肝失代偿患者、接受免疫抑制或化疗的患者以及肝移植和肝细胞癌患者。