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慢性乙型肝炎及其相关肝硬化抗病毒治疗:单药还是联合?
Anti-viral therapy for chronic hepatitis B and cirrhosis: monotherapy or combination?
文章发布日期:2015年02月12日  来源:  作者:施漪雯,王 麟,尤 红  点击次数:2187次  下载次数:562次

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【摘要】:目前慢性乙型肝炎的抗病毒治疗应答率仍有待提高,不少学者开始尝试联合用药,包括核苷和核苷酸类药物之间的联用和干扰素与核苷和核苷酸类药物的联用。回顾近期国内外经验发现,初治慢性乙型肝炎患者可首选强效低耐药核苷和核苷酸类药物单药治疗,普通核苷和核苷酸类药物耐药患者可换用替诺福韦。高病毒载量及HBeAg阳性的患者,推荐核苷和核苷酸类药物的联合治疗。既往经治甚至多重耐药的患者可以选择恩替卡韦与替诺福韦联用。核苷和核苷酸类药物经治、期待HBeAg和HBsAg血清学转换的患者,可以考虑加用长效干扰素。
【Abstract】:At present, the response rate of anti-viral therapy for chronic hepatitis B still needs to be increased. Therefore, combination therapy including nucleosides combined with nucleotides, as well as interferon combined with nucleosides and nucleotides, is being explored by many researchers. According to recent studies, monotherapy using potent nucleosides or nucleotides is the first choice for initial treatment of chronic hepatitis B, and tenofovir is an alternative choice for nucleosides- and nucleotides-resistant patients. Combination therapy using nucleosides and nucleotides is recommended for patients with high viral load and positive HBeAg. Entecavir combined with tenofovir can be used for patients with a treatment history and even for those with multiple drug resistance. The long-term therapy with interferon can be used to achieve HBeAg and HBsAg seroconversion in patients already treated with nucleosides and nucleotides.
【关键字】:肝炎,乙型,慢性;抗病毒药;干扰素类
【Key words】:hepatitis B, chronic; antiviral agents; interferons
【引证本文】:

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