Zhang Mengyang, Kong Yuanyuan, Xu Xiaoqian, Sun Yameng, Jia Jidong, You Hong
Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, State Key Lab of Digestive Health, Beijing, China.
Clinical Epidemiology and EBM Unit, Beijing Friendship Hospital, Capital Medical University, Beijing Clinical Research Institute, Beijing, China.
J Clin Transl Hepatol. 2024 Jun 28;12(6):589-593. doi: 10.14218/JCTH.2024.00091. Epub 2024 May 28.
Chronic hepatitis B remains the primary cause of liver-related events in China. The World Health Organization set a goal to eliminate viral hepatitis as a public health threat by 2030. However, achieving this goal appears challenging due to the current low rates of diagnosis and treatment. The "Treat-all" strategy, which proposes treating all patients with detectable hepatitis B virus (HBV) DNA or even all patients with positive HBsAg, has been suggested to simplify anti-HBV treatment. In 2022, the Chinese Society of Hepatology and the Chinese Society of Infectious Diseases updated the guidelines for the prevention and treatment of chronic hepatitis B in China, expanding antiviral indications and simplifying the treatment algorithm. According to this latest guideline, nearly 95% of patients with detectable HBV DNA are eligible for antiviral treatment. This review aimed to provide a detailed interpretation of the treatment indications outlined in the Chinese (version 2022) and to identify gaps in achieving the "Treat-all" strategy in China.
慢性乙型肝炎仍是中国肝脏相关疾病的主要病因。世界卫生组织设定了到2030年消除病毒性肝炎这一公共卫生威胁的目标。然而，由于目前诊断和治疗率较低，实现这一目标似乎具有挑战性。“全面治疗”策略建议对所有可检测到乙肝病毒（HBV）DNA的患者甚至所有HBsAg阳性患者进行治疗，以简化抗HBV治疗。2022年，中华医学会肝病学分会和中华医学会感染病学分会更新了中国慢性乙型肝炎防治指南，扩大了抗病毒适应证并简化了治疗方案。根据这一最新指南，近95%可检测到HBV DNA的患者符合抗病毒治疗条件。本综述旨在详细解读中国（2022年版）指南中列出的治疗适应证，并找出中国在实现“全面治疗”策略方面存在的差距。
