Impact of hepatitis B therapy on the long-term outcome of liver disease
Impact of hepatitis B therapy on the long-term outcome of liver disease
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DOI：
10.1111/j.1478-3231.2010.02388.x
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发表时间：
2011-01-01
影响因子：
6.7
通讯作者：
Liaw, Yun-Fan
中科院分区：
文献类型：
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作者：
Liaw, Yun-Fan
慢性乙型肝炎病毒（HBV）感染是HBV、肝细胞和患者免疫系统之间一系列动态相互作用的过程。HBV复制是疾病进展的关键动力，包括肝硬化和肝细胞癌（HCC）的发展。消除或抑制HBV可降低发生肝病的风险或减缓肝病的进展。研究表明，有限疗程的常规干扰素- α (IFN)治疗为实现累积反应以及减少纤维化进展和肝硬化和/或HCC的发展提供了长期益处。核苷类似物（NUCs）的长期治疗也可能改善纤维化或逆转晚期纤维化，并减少疾病进展和HCC的发生。及时使用无交叉耐药的抢救NUCs可克服与耐药有关的问题。聚乙二醇化IFN （PEG-IFN）和新型NUCs的结果可能更好，因为治疗更有效和/或耐药风险更低。然而，治疗结果仍然需要改善，需要更有效、安全、负担得起的抗hbv药物/策略。
Chronic hepatitis B virus (HBV) infection is a dynamic series of interactions between HBV, hepatocytes and the patient's immune system. HBV replication is the key motor of disease progression, including the development of cirrhosis and hepatocellular carcinoma (HCC). HBV elimination or suppression can reduce the risk of or slow the progression of liver disease. Studies have shown that a finite course of conventional interferon-alpha (IFN) therapy provides long-term benefit for achieving a cumulative response as well as reducing the progression of fibrosis and the development of cirrhosis and/or HCC. Long-term therapy with nucleos(t)ide analogues (NUCs) may also improve fibrosis or reverse advanced fibrosis as well as reduce disease progression and the development of HCC. The problems associated with drug resistance can be overcome by the timely use of rescue NUCs without cross-resistance. The outcome with pegylated IFN (PEG-IFN) and newer NUCs may be even better because of more effective treatment and/or a low risk of resistance. However, the treatment outcomes still need to be improved, and more effective, safe and affordable anti-HBV agents/strategies are needed.