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目前,对于治疗一些慢性乙型肝炎病毒(HBV)感染边缘病例的最佳方法尚存在争议。血清HBV DNA和转氨酶水平、炎性坏死的程度和肝硬变程度决定着治疗的方案。所有转氨酶升高(>正常上限值2倍)和血清HBV DNA>20000IU/mL的患者都需进行治疗。肝脏活检对于制定转氨酶轻度升高和血清HBV DNA<20000IU/mL的病例的治疗决策非常重要。慢性HBV患者如未接受治疗则需长期随访。现有7种药物获批用于治疗慢性乙型肝炎:普通和聚乙二醇IFNα、拉米夫定、阿德福韦、恩替卡韦、替比夫定和替诺福韦。应用聚乙二醇IFNα1年疗程后持续治疗后效应使HbeAg阳性慢性乙型肝炎患者缓解率为30%-32%。口服抗病毒药物适用于大部分患者,并被用于长期治疗。然而,病毒耐药是长期口服抗病毒药物的主要缺点。
Currently, the best way to treat some of the edge cases of chronic Hepatitis B virus (HBV) infection remains controversial. Serum HBV DNA and aminotransferase levels, the degree of inflammatory necrosis, and the degree of cirrhosis determine the regimen for treatment. All patients with elevated transaminases (> 2x upper limit of normal) and serum HBV DNA> 20,000 IU / mL are required for treatment. Liver biopsy is important for making therapeutic decisions in patients with mild transaminases and serum HBV DNA <20000 IU / mL. Chronic HBV patients need long-term follow-up without treatment. Seven existing drugs are approved for the treatment of chronic hepatitis B: normal and polyethylene glycol IFNα, lamivudine, adefovir, entecavir, telbivudine and tenofovir. Application of polyethylene glycol IFNα1 years after treatment continued treatment of hypotensive HbeAg-positive chronic hepatitis B response rate was 30% -32%. Oral antiviral drugs are suitable for most patients and are used for long-term treatment. However, viral resistance is a major drawback of long-term oral antiviral drugs.