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本文引用的文献

1
Clinical Consensus Statement No. 458: Hepatitis C Virus in Pregnancy.临床共识声明第458号:妊娠期间的丙型肝炎病毒
J Obstet Gynaecol Can. 2025 Feb;47(2):102780. doi: 10.1016/j.jogc.2025.102780.
2
Long-term outcome of hepatitis delta in different regions world-wide: Results of the Hepatitis Delta International Network.全球不同地区丁型肝炎的长期结局:丁型肝炎国际网络的研究结果。
Liver Int. 2024 Sep;44(9):2442-2457. doi: 10.1111/liv.16006. Epub 2024 Jun 18.
3
Bulevirtide Combined with Pegylated Interferon for Chronic Hepatitis D.布乐瑞肽联合聚乙二醇干扰素治疗慢性丁型肝炎。
N Engl J Med. 2024 Jul 11;391(2):133-143. doi: 10.1056/NEJMoa2314134. Epub 2024 Jun 6.
4
Tenofovir Alafenamide Versus Tenofovir Disoproxil Fumarate for Preventing Vertical Transmission in Chronic Hepatitis B Mothers: A Systematic Review and Meta-Analysis.替诺福韦艾拉酚胺与富马酸替诺福韦二吡呋酯预防慢性乙型肝炎母亲母婴垂直传播的效果比较:系统评价与荟萃分析。
Clin Infect Dis. 2024 Oct 15;79(4):953-964. doi: 10.1093/cid/ciae288.
5
Evaluation of a fully automated high-throughput serology assay for detection of Hepatitis D virus antibodies.评价一种全自动高通量酶联免疫吸附试验检测抗乙型肝炎病毒抗体的方法。
J Clin Virol. 2024 Aug;173:105689. doi: 10.1016/j.jcv.2024.105689. Epub 2024 May 8.
6
An updated assessment of hepatitis delta prevalence among adults in Canada: A meta-analysis.加拿大成年人中乙型肝炎 delta 流行率的最新评估:一项荟萃分析。
J Viral Hepat. 2024 Jun;31(6):324-341. doi: 10.1111/jvh.13939. Epub 2024 Apr 15.
7
Is there a need for universal double reflex testing of HBsAg-positive individuals for hepatitis D infection?对于乙肝表面抗原(HBsAg)阳性个体,是否需要进行普遍的丁型肝炎双重反射检测?
World J Hepatol. 2024 Mar 27;16(3):300-303. doi: 10.4254/wjh.v16.i3.300.
8
Factors associated with knowledge and awareness of Hepatitis B in individuals of Chinese descent: Results from a mass point of care testing and outreach campaign in Toronto, Canada.华裔个体中与乙肝知识和意识相关的因素:加拿大多伦多一项大规模即时检测及外展活动的结果
Can Liver J. 2024 Feb 26;7(1):28-39. doi: 10.3138/canlivj-2023-0015. eCollection 2024 Feb.
9
Reply to: "Ultrasensitive HBsAg testing predicts HBsAg seroreversion outcomes: Considerations for new and existing therapies".回复:“超敏乙肝表面抗原检测可预测乙肝表面抗原血清学转换结果:对新疗法和现有疗法的考量”
J Hepatol. 2024 Jul;81(1):e26-e27. doi: 10.1016/j.jhep.2024.03.001. Epub 2024 Mar 8.
10
Impact of anti-HDV reflex testing at HBs antigen positive discovery in a single center France: Support for primary HDV screening in France.法国某单一中心在乙肝表面抗原阳性检测时进行抗丁型肝炎病毒反射检测的影响:对法国原发性丁型肝炎病毒筛查的支持
J Clin Virol. 2024 Apr;171:105650. doi: 10.1016/j.jcv.2024.105650. Epub 2024 Feb 3.

《慢性乙型肝炎的管理:加拿大肝脏研究协会和加拿大医学微生物学与传染病协会2025年指南更新》

The Management of Chronic Hepatitis B: 2025 Guidelines Update from the Canadian Association for the Study of the Liver and Association of Medical Microbiology and Infectious Disease Canada.

作者信息

Osiowy Carla, Alvarez Fernando, Coffin Carla S, Cooper Curtis L, Fung Scott K, Ko Hin Hin, Poulin Sébastien, van Gennip Jennifer

机构信息

Viral Hepatitis and Blood-borne Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.

Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.

出版信息

Can Liver J. 2025 May 26;8(2):368-440. doi: 10.3138/canlivj-2025-0012-e. eCollection 2025 May.

DOI:10.3138/canlivj-2025-0012-e
PMID:40677987
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12269321/
Abstract

Chronic hepatitis B virus (HBV) infection poses significant public health challenges in Canada, particularly among newcomers from regions with high HBV prevalence. In alignment with the World Health Organization's goal of HBV elimination by 2030, this 2025 guidelines update-developed jointly by the Canadian Association for the Study of the Liver (CASL) and the Association of Medical Microbiology and Infectious Disease (AMMI) Canada-presents recommendations for universal adult HBV screening, vaccination, laboratory assessment, and treatment. These guidelines emphasize patient-centred care, early diagnosis, and expanded antiviral treatment, including for individuals in the indeterminate or and special populations such as pregnant individuals, children, and those coinfected with HIV, hepatitis C, or hepatitis D. Notably, the guidelines recommend reflex HDV testing and routine use of quantitative HBsAg to support management decisions. These evidence-based recommendations are informed by expert consensus, recent literature, and international standards, with the aim of improving outcomes, reducing stigma, and informing future policy and research priorities.

摘要

慢性乙型肝炎病毒(HBV)感染在加拿大构成了重大的公共卫生挑战,尤其是在来自HBV高流行地区的新移民中。为了与世界卫生组织到2030年消除HBV的目标保持一致,这份2025年指南更新版由加拿大肝脏研究协会(CASL)和加拿大医学微生物学与传染病协会(AMMI)联合制定,提出了针对成人普遍进行HBV筛查、疫苗接种、实验室评估和治疗的建议。这些指南强调以患者为中心的护理、早期诊断以及扩大抗病毒治疗,包括针对处于不确定状态的个体以及孕妇、儿童和同时感染HIV、丙型肝炎或丁型肝炎等特殊人群。值得注意的是,指南建议进行反射性HDV检测并常规使用定量HBsAg以支持管理决策。这些基于证据的建议是由专家共识、近期文献和国际标准得出的,目的是改善治疗效果、减少耻辱感,并为未来的政策和研究重点提供参考。