乙型肝炎评估与管理的当前观点：综述
Current perspectives into the evaluation and management of hepatitis B: a review.
作者信息
Manne Vignan, Gochanour Eric, Kowdley Kris V
机构信息
Liver Care Network, Swedish Medical Center, Seattle, WA, USA.
出版信息
Hepatobiliary Surg Nutr. 2019 Aug;8(4):361-369. doi: 10.21037/hbsn.2019.02.09.
Abstract
Hepatitis B is a widespread disease which affects millions of people worldwide. Chronic hepatitis B (CHB) can lead to significant morbidity and mortality due to complications such as cirrhosis and hepatocellular carcinoma. The pathophysiology of hepatitis is critical to diagnosing CHB. Deciding which patients with CHB should be treated is an important decision as treatment can often lead to better outcomes in the appropriate patient population. The nucleos(t)ide analog inhibitors entecavir and tenofovir are currently the mainstay of treatment as they are able to successfully suppress the virus and lead to fewer complications. Novel therapies are currently being developed which may offer a potential cure for this disease in the future.
摘要
乙型肝炎是一种广泛传播的疾病，影响着全球数百万人。慢性乙型肝炎（CHB）可因肝硬化和肝细胞癌等并发症导致严重的发病和死亡。肝炎的病理生理学对于诊断CHB至关重要。决定哪些CHB患者应接受治疗是一项重要决策，因为在合适的患者群体中进行治疗通常可带来更好的结果。核苷（酸）类似物抑制剂恩替卡韦和替诺福韦目前是治疗的主要药物，因为它们能够成功抑制病毒并减少并发症。目前正在研发新的疗法，未来可能为这种疾病提供潜在的治愈方法。
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本文引用的文献
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J Hepatol. 2018 Nov;69(5):1066-1073. doi: 10.1016/j.jhep.2018.07.018. Epub 2018 Aug 1.
2
Association of Preoperative Antiviral Treatment With Incidences of Microvascular Invasion and Early Tumor Recurrence in Hepatitis B Virus-Related Hepatocellular Carcinoma.术前抗病毒治疗与乙型肝炎病毒相关性肝细胞癌微血管侵犯和早期肿瘤复发的关系。
JAMA Surg. 2018 Oct 1;153(10):e182721. doi: 10.1001/jamasurg.2018.2721. Epub 2018 Oct 17.
3
Access to Treatment for Hepatitis B Virus Infection - Worldwide, 2016.乙型肝炎病毒感染治疗的可及性 - 全球，2016 年。
MMWR Morb Mortal Wkly Rep. 2018 Jul 20;67(28):773-777. doi: 10.15585/mmwr.mm6728a2.
4
Reduced Incidence of Hepatocellular Carcinoma in Cirrhotic and Noncirrhotic Patients With Chronic Hepatitis B Treated With Tenofovir-A Propensity Score-Matched Study.替诺福韦治疗慢性乙型肝炎的肝硬化和非肝硬化患者中肝细胞癌发生率降低：一项倾向评分匹配研究。
J Infect Dis. 2019 Jan 1;219(1):10-18. doi: 10.1093/infdis/jiy391.
5
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Am J Gastroenterol. 2018 Jul;113(7):998-1008. doi: 10.1038/s41395-018-0093-9. Epub 2018 Jun 8.
6
Chronic Hepatitis B Infection: A Review.慢性乙型肝炎感染：综述。
JAMA. 2018 May 1;319(17):1802-1813. doi: 10.1001/jama.2018.3795.
7
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J Hepatol. 2018 Aug;69(2):278-285. doi: 10.1016/j.jhep.2018.02.032. Epub 2018 Mar 16.
8
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