Beijing 302-Hong Kong Humanity and Health Hepatitis C Diagnosis and Treatment Center, Beijing, China.
Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China.
Liver Int. 2017 Jan;37 Suppl 1:59-66. doi: 10.1111/liv.13309.
Since the registration of the first effective nucleoside analogue against the hepatitis B virus almost two decades ago, major progress has been made in the management of chronic hepatitis B infection. However, hepatitis B-related morbidity and mortality remain a major global health threat. This is partly due to the escalating costs and the decrease in compliance related to the need for prolonged therapy for most patients who cannot be "cured". New biomarkers such as quantitative hepatitis B surface antigen might help to determine if hepatitis B e antigen negative patients can be taken off nucleos(t)ide analogues. On the other hand, novel compounds that target the viral life cycle or modulate host immune response are in the pipeline. In the next few years, one should expect breakthrough advancement to be made leading to a "cure" for patients with chronic hepatitis B infection by inducing hepatitis surface antigen loss with or without the development of the hepatitis B surface antibody. In addition, attention and necessary actions should also be taken in patients with hepatitis B infection who are being treated with immunosuppressive therapy and direct anti-viral (DAAs) agents for hepatitis C infection to prevent hepatitis from hepatitis B reactivation.
自近二十年前注册第一种针对乙型肝炎病毒的有效核苷类似物以来，慢性乙型肝炎感染的管理已取得重大进展。然而，乙型肝炎相关发病率和死亡率仍然是一个主要的全球健康威胁。这在一定程度上是由于治疗大多数不能“治愈”的患者需要长期治疗而导致的成本不断上升和依从性下降。新的生物标志物，如定量乙型肝炎表面抗原，可能有助于确定乙型肝炎 e 抗原阴性患者是否可以停用核苷（酸）类似物。另一方面，针对病毒生命周期或调节宿主免疫反应的新型化合物正在研发中。在未来几年，人们应该期待能够取得突破性进展，通过诱导乙型肝炎表面抗原丢失（无论是否产生乙型肝炎表面抗体），为慢性乙型肝炎感染患者带来“治愈”。此外，还应关注并采取必要措施，防止乙型肝炎再激活，在接受免疫抑制治疗和直接抗病毒（DAAs）药物治疗丙型肝炎感染的乙型肝炎感染患者中。
