Sinn Dong Hyun
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2019 Nov 25;74(5):245-250. doi: 10.4166/kjg.2019.74.5.245.
HBV is the most common etiology of both liver cirrhosis and hepatocellular carcinoma in Korea. Despite much progress made, the currently available antiviral therapies cannot eradicate or eliminate this virus. Hence, the benefits and risks of antiviral therapy should be carefully evaluated on an individual basis and within the context of the clinical situation. The ultimate goals of treatment are to decrease the mortality from liver disease. The benefits of antiviral therapy come from prevention of progression of liver disease. Understanding the natural history of chronic HBV infection is a key step in the decision making process to treat patients with chronic HBV infection. Generally, chronic hepatitis B patients in the immune tolerant phase and immune inactive phase are not recommended to undergo antiviral treatment, except for those patients in special conditions (e.g., immunosuppression or anticancer chemotherapy). Chronic hepatitis B patients in the immune active phase are recommended for antiviral therapy. For patients with liver cirrhosis, treatment should be considered when serum HBV DNA is detectable regardless of the serum level of ALT.
在韩国，乙肝病毒（HBV）是肝硬化和肝细胞癌最常见的病因。尽管已取得很大进展，但目前可用的抗病毒疗法无法根除或清除这种病毒。因此，应根据个体情况并结合临床状况仔细评估抗病毒治疗的益处和风险。治疗的最终目标是降低肝病死亡率。抗病毒治疗的益处源于预防肝病进展。了解慢性HBV感染的自然史是决定是否治疗慢性HBV感染患者的关键步骤。一般来说，免疫耐受期和免疫非活动期的慢性乙型肝炎患者不建议进行抗病毒治疗，但特殊情况（如免疫抑制或抗癌化疗）的患者除外。免疫活动期的慢性乙型肝炎患者建议进行抗病毒治疗。对于肝硬化患者，无论谷丙转氨酶（ALT）血清水平如何，只要血清HBV DNA可检测到，就应考虑进行治疗。
