Clinical controversies over antiviral therapy for patients in the immune-tolerant phase of hepatitis B virus infection
10.12449/JCH240505
- VernacularTitle:免疫耐受期HBV感染者抗病毒治疗的临床争议
- Author:
Linhui HU
1
;
Yan WANG
Author Information
1. 北京大学第一医院感染科,北京 100034
- Keywords:
Hepatitis B virus;
Immune Tolerance;
Therapeutics
- From:
Journal of Clinical Hepatology
2024;40(5):875-879
- CountryChina
- Language:Chinese
-
Abstract:
To achieve the goal of"eliminating viral hepatitis as a public health hazard by 2030",extensive screening,active prevention,and antiviral therapy are currently recommended for chronic hepatitis B virus(HBV)infection;however,no consensus has been reached on whether to initiate antiviral therapy for patients in the immune-tolerant phase of chronic HBV infection.Some experts believe that patients in the immune-tolerant phase tend to have a stable liver immune microenvironment,with a low risk of disease progression and poor response to treatment,and thus it is not recommended to initiate antiviral therapy.However,various other studies have shown that patients in the immune-tolerant phase still have inflammatory damage in the liver,with a risk of disease progression and a high level of cost effectiveness,and therefore,some experts suggest that antiviral therapy should be actively initiated for patients in the immune-tolerant phase.This article performs a literature review of the definition of patients in the immune-tolerant phase of chronic HBV infection and the advantages and disadvantages of antiviral therapy and conducts a preliminary analysis based on previous studies,in order to accumulate the evidence for whether to initiate antiviral therapy in the immune-tolerant phase of chronic HBV infection and lay a foundation for standardized clinical diagnosis and treatment of patients in the immune-tolerant phase.
