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欧洲肝脏研究学会关于乙型肝炎病毒感染管理的临床实践指南。

EASL Clinical Practice Guidelines on the management of hepatitis B virus infection.

机构信息

European Association for the Study of the Liver (EASL). The EASL Building - Home of Hepatology, 7 rue Daubin, 1203 Geneva, Switzerland.

出版信息

J Hepatol. 2025 Aug;83(2):502-583. doi: 10.1016/j.jhep.2025.03.018. Epub 2025 May 10.

Abstract

The updated EASL Clinical Practice Guidelines on the management of hepatitis B virus (HBV) infection provide comprehensive, evidence-based recommendations for its management. Spanning ten thematic sections, the guidelines address diagnostics, treatment goals, treatment indications, therapeutic options, hepatocellular carcinoma surveillance, management of special populations, HBV reactivation prophylaxis, post-transplant care, HBV prevention strategies, and finally address open questions and future research directions. Chronic HBV remains a global health challenge, with over 250 million individuals affected and significant mortality due to cirrhosis and hepatocellular carcinoma. These guidelines emphasise the importance of early diagnosis, risk stratification based on viral and host factors, and tailored antiviral therapy. Attention is given to simplified algorithms, vaccination, and screening to support global HBV elimination targets. The guidelines also discuss emerging biomarkers and evolving definitions of functional and partial cure. Developed through literature review, expert consensus, and a Delphi process, the guidelines aim to equip healthcare providers across disciplines with practical tools to optimise HBV care and outcomes worldwide.

摘要

最新版的《欧洲肝脏研究学会(EASL)乙型肝炎病毒(HBV)感染管理临床实践指南》为HBV感染的管理提供了全面的、基于证据的建议。该指南涵盖十个主题部分,涉及诊断、治疗目标、治疗指征、治疗选择、肝细胞癌监测、特殊人群管理、HBV再激活预防、移植后护理、HBV预防策略,最后探讨了未解决的问题和未来的研究方向。慢性HBV仍然是一项全球性的健康挑战——超过2.5亿人受到影响,并且因肝硬化和肝细胞癌导致了相当高的死亡率。这些指南强调了早期诊断、基于病毒和宿主因素进行风险分层以及量身定制抗病毒治疗的重要性。指南还关注简化的算法、疫苗接种和筛查,以支持全球消除HBV的目标。指南还讨论了新兴的生物标志物以及功能性治愈和部分治愈不断演变的定义。该指南通过文献综述、专家共识和德尔菲法制定,旨在为各学科的医疗保健提供者提供实用工具,以在全球范围内优化HBV护理并改善治疗结果。

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