Chronic hepatitis B virus infection

被引:383
|
作者
Seto, Wai-Kay [1 ,2 ,3 ]
Lo, Ying-Ru [4 ]
Pawlotsky, Jean-Michel [5 ,6 ]
Yuen, Man-Fung [1 ,2 ,3 ]
机构
[1] Univ Hong Kong, Queen Mary Hosp, Dept Med, Hong Kong, Hong Kong, Peoples R China
[2] Univ Hong Kong, Shenzhen Hosp, Dept Med, Shenzhen, Guangdong, Peoples R China
[3] Univ Hong Kong, Lab Liver Res, Hong Kong, Hong Kong, Peoples R China
[4] WHO Representat Off Malaysia Brunei Darussalam &, Cyberjaya, Malaysia
[5] Univ Paris Est, Henri Mondor Hosp, Dept Virol, Natl Reference Ctr Viral Hepatitis B C & Delta, Creteil, France
[6] INSERM, U955, Dept Mol Virol & Immunol, Creteil, France
来源
LANCET | 2018年 / 392卷 / 10161期
关键词
TENOFOVIR DISOPROXIL FUMARATE; NUCLEOS(T)IDE ANALOG THERAPY; RANDOMIZED CONTROLLED-TRIAL; RNA INTERFERENCE THERAPY; E-ANTIGEN SEROCONVERSION; TREATMENT-NAIVE PATIENTS; PERSISTENTLY NORMAL ALT; CHRONIC LIVER-FAILURE; TERM-FOLLOW-UP; HEPATOCELLULAR-CARCINOMA;
D O I
10.1016/S0140-6736(18)31865-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic hepatitis B virus infection is a global public health threat that causes considerable liver-related morbidity and mortality. It is acquired at birth or later via person-to-person transmission. Vaccination effectively prevents infection and chronic hepatitis B virus carriage. In chronically infected patients, an elevated serum hepatitis B virus DNA concentration is the main risk factor for disease progression, although there are other clinical and viral parameters that influence disease outcomes. In addition to liver biochemistry, virological markers, and abdominal ultrasonography, non-invasive assessment of liver fibrosis is emerging as an important assessment modality. Long-term nucleos(t)ide-analogue therapy is safe and well tolerated, achieves potent viral suppression, and reduces the incidence of liver-related complications. However, a need to optimise management remains. Promising novel therapies are at the developmental stage. With current vaccines, therapies, and an emphasis on improving linkage to care, WHO's goal of eliminating hepatitis B virus as a global health threat by 2030 is achievable.
引用
收藏
页码:2313 / 2324
页数:12
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