Thoughts on expert opinion on expanding antiviral therapy for chronic hepatitis B
10.3969/j.issn.1001-5256.2023.01.002
- VernacularTitle:关于《扩大慢性乙型肝炎抗病毒治疗的专家意见》的几点思考
- Author:
Zhihong LIU
1
,
2
;
Xieer LIANG
1
,
2
;
Jinlin HOU
1
,
2
Author Information
1. Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
2. Institutes of Liver Diseases Research of Guangdong Province, Guangzhou 510515, China
- Publication Type:Discussions by Experts
- Keywords:
Hepatitis B, Chronic;
Alanine Transaminase;
Low Level Viremia
- From:
Journal of Clinical Hepatology
2023;39(1):14-21
- CountryChina
- Language:Chinese
-
Abstract:
Expanding antiviral therapy is currently the new trend for the diagnosis and treatment of chronic hepatitis B, and related research evidence should be studied and discussed. Reducing the threshold of alanine aminotransferase (ALT) for initiating antiviral therapy is one of the most important changes during the expansion of antiviral therapy. Chronic hepatitis B patients with a low-level increase in ALT or a high normal level of ALT still have a higher risk of liver cancer and thus require further intervention. At present, nucleos(t)ide analogues show a certain clinical effect in some patients in terms of virological inhibition and improvement in fibrosis, while reducing ALT threshold places higher requirements for biochemical response after treatment. In addition, although the mechanism and definition of low-level viremia (LLV) after treatment remain unclear, further intervention of LLV is an important strategy for optimizing patient management in clinical practice. Switch to another potent nucleos(t)ide analogue may improve the virologic response rate of patients with LLV, and nucleos(t)ide analogues combined with interferon or other new targeted drugs will be an important research direction for the treatment of LLV in the future.
