Wong Grace Lai-Hung
Department of Medicine and Therapeutics, Medical Data Analytics Centre, Hong Kong, China.
State Key Laboratory of Digestive Disease, Institute of Digestive Disease The Chinese University of Hong Kong, Hong Kong, SAR, China.
J Viral Hepat. 2024 Dec;31 Suppl 2:13-22. doi: 10.1111/jvh.14032. Epub 2024 Nov 6.
The year 2024 is the year of new clinical practice and management guidelines for chronic hepatitis B virus (HBV) infection. World Health Organization (WHO) published the updated HBV guidelines in March 2024. In contrast, two key international societies for liver diseases, including the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL), are currently in the process of updating their clinical practice guidelines for HBV. In 2022, China published their HBV guidelines, regarded as one of the most uncompromising ones as the threshold to start antiviral treatment is set at detectable HBV DNA above 10-20 IU/mL. In this chapter, the latest developments in the HBV guidelines with a specific focus on the Chinese & WHO guidelines are discussed. Specifically, the pros and cons of lowering treatment thresholds and the benefits of treating more people to avoid the complications of chronic hepatitis B, specifically HCC, are reviewed.
2024年是慢性乙型肝炎病毒(HBV)感染新临床实践和管理指南发布的一年。世界卫生组织(WHO)于2024年3月发布了更新后的HBV指南。相比之下,包括美国肝病研究协会(AASLD)和欧洲肝脏研究协会(EASL)在内的两个关键国际肝病学会目前正在更新其HBV临床实践指南。2022年,中国发布了HBV指南,该指南被认为是最严格的指南之一,因为开始抗病毒治疗的阈值设定为可检测到的HBV DNA高于10-20 IU/mL。在本章中,将讨论HBV指南的最新进展,特别关注中国和WHO指南。具体而言,将回顾降低治疗阈值的利弊以及治疗更多患者以避免慢性乙型肝炎并发症(特别是肝癌)的益处。