Step-down affordable treatment for chronic hepatitis B infection in Africa and India Acronym - STEP-HEP

慢性感染B型肝炎病毒在发展中国家很常见。如果没有治疗，很大一部分感染者将发展为肝病（肝硬化和肝癌），导致过早死亡。B型肝炎的有效治疗是可行的，但在发展中国家广泛使用的费用太高。我们计划研究一种治疗慢性B型肝炎的新方法。我们将开始用一种昂贵但非常强大的药物--替诺福韦--进行治疗，当B型肝炎得到控制后，我们将退而用一种较弱但便宜得多的药物--拉米夫定。我们将确保这种方法是安全的，检查任何人谁不响应拉米夫定可以有效地治疗重新引入替诺福韦。监测慢性B型肝炎患者治疗的最佳方法是使用非常复杂，昂贵的测试来测量血液中的病毒量。这些检测在发展中国家通常无法获得，因此我们将确定是否可以使用简单，廉价的肝脏炎症检测来监测接受B型肝炎治疗的患者。

Chronic infection with the hepatitis B virus is common in the developing world. Without therapy a large proportion of those who are infected will develop liver disease (cirrhosis and liver cancer) that will lead to premature death. Effective treatments for hepatitis B are available but they are too costly for wide spread use in the developing world.We plan to investigate a new approach to treating chronic hepatitis B. We will initiate therapy with an expensive, but very powerful, drug - tenofovir - and, when the hepatitis B is controlled, we will step down to a weaker, but much cheaper drug - lamivudine. We will ensure that this approach is safe by checking that anyone who does not respond to lamivudine can be effectively treated by the re-introduction of tenofovir. The best way to monitor treatment in people with chronic hepatitis B is to measure the amount of virus in the blood using very sophisticated, expensive test. These tests are often not available in the developing world and we will therefore determine whether or not we can use simple, cheap tests of liver inflammation to monitor patients receiving treatment for hepatitis B.