Zhonghua Gan Zang Bing Za Zhi. 2019 Aug 20;27(8):594-603. doi: 10.3760/cma.j.issn.1007-3418.2019.08.003.
Chronic hepatitis B virus (HBV) infection remains a major world public health problem. Current guidelines for the prevention and treatment of chronic hepatitis B (CHB) have suggested clinical cure (also known as functional cure) as the ideal therapeutic goal, which is associated with decreased risk of cirrhosis and hepatocellular carcinoma. Clinical cure is defined as sustained, undetectable serum HBsAg, HBeAg and HBV DNA with or without seroconversion to anti-HBs, but with the persistence of residual cccDNA, accompanied by resolution of liver injury after the completion of a finite course of treatment. Accumulating data from a series of randomized controlled trials as well as clinical practice have confirmed certain clinical benefit of optimal sequential/ combination strategies of direct acting antiviral drugs (DAA) [such as nucleoside analogues (NA)] or immunomodulators (such as pegylated interferon alpha (Peg-IFN)] for appropriately selected CHB patients. This consensus provides an updated and comprehensive analysis of the data supporting the use of combination therapies and summarizes the roadmap towards clinical cure of CHB to guide decision-making in clinical practice.
慢性乙型肝炎病毒（HBV）感染仍然是一个重大的全球公共卫生问题。当前慢性乙型肝炎（CHB）防治指南已将临床治愈（也称为功能性治愈）作为理想的治疗目标，这与降低肝硬化和肝细胞癌风险相关。临床治愈定义为血清HBsAg、HBeAg和HBV DNA持续检测不到，伴或不伴有抗-HBs血清学转换，但残留cccDNA持续存在，且在有限疗程结束后肝损伤得到缓解。一系列随机对照试验以及临床实践积累的数据已证实，对于适当选择的CHB患者，直接抗病毒药物（DAA）[如核苷类似物（NA）]或免疫调节剂[如聚乙二醇化干扰素α（Peg-IFN）]的最佳序贯/联合策略具有一定临床益处。本共识对支持联合治疗的数据进行了更新和全面分析，并总结了CHB临床治愈的路线图，以指导临床实践中的决策。
