Han C, Dou X G
Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang 110022, China.
Zhonghua Gan Zang Bing Za Zhi. 2021 Apr 20;29(4):293-296. doi: 10.3760/cma.j.cn501113-20210326-00139.
Patients with chronic hepatitis B (CHB) who cannot receive effective antiviral therapy timely will eventually develop liver cirrhosis and/or hepatocellular carcinoma (HCC). Therefore, receiving nucleos(t)ide analogues (NAs) therapy can effectively inhibit hepatitis B virus (HBV) replication, improve liver tissue inflammation and fibrosis, prevent or delay the disease progression, and greatly reduce the occurrence of HBV-related HCC. However, it is often found in clinical practice that some patients treated with long-term NAs therapy can still develop HCC despite the effective inhibition of HBV replication. This phenomenon has attracted widespread concern and discussion. In this article, we focus on whether NAs can significantly reduce the occurrence of HCC while effectively inhibiting HBV replication, or HCC can still occur. Additionally, discuss the possible causes of HCC after NAs therapy, including the types of drugs, treatment timing, incomplete response, etc., in order to help clinicians implement antiviral treatment more accurately, and further reduce HBV-related HCC.
慢性乙型肝炎(CHB)患者若不能及时接受有效的抗病毒治疗,最终会发展为肝硬化和/或肝细胞癌(HCC)。因此,接受核苷(酸)类似物(NAs)治疗可有效抑制乙型肝炎病毒(HBV)复制,改善肝组织炎症和纤维化,预防或延缓疾病进展,并大大降低HBV相关HCC的发生。然而,临床实践中经常发现,一些接受长期NAs治疗的患者尽管HBV复制得到有效抑制,但仍会发生HCC。这一现象引起了广泛关注和讨论。在本文中,我们关注NAs在有效抑制HBV复制的同时是否能显著降低HCC的发生,或者HCC是否仍会发生。此外,探讨NAs治疗后HCC发生的可能原因,包括药物类型、治疗时机、不完全应答等,以帮助临床医生更准确地实施抗病毒治疗,并进一步降低HBV相关HCC的发生。