A personalized approach to optimize hepatitis B treatment in treatment-naive pat

StephenW

Antivir Ther. 2010;15 Suppl 3:53-9.

A personalized approach to optimize hepatitis B treatment in
treatment-naive patients.

Marcellin P, Liang J.

Service d'Hépatologie, Hôpital Beaujon, AP-HP, Clichy, France.
[email protected]

Abstract
In a treatment-naive patient with chronic hepatitis B, a personalized
approach allows treatment efficacy to be optimized. Firstly, the selection
of good candidates for therapy is crucial. Patients with chronic active
hepatitis B--with relatively low levels of HBV DNA replication (<10(9)
copies/ml) and relatively high alanine aminotransferase (ALT) levels--are
good candidates for therapy. By contrast, patients with chronic hepatitis
B in the immunotolerance phase, who have high levels of HBV DNA and
persistently normal ALT levels, as well as inactive hepatitis B surface
antigen (HBsAg) carriers with low HBV DNA and normal ALT levels do not
have an indication for therapy as they are poor responders. Secondly, the
characteristics of the patient (for example, gender, age, immune status,
general health status and comorbidities), the characteristics of the liver
disease (for example, presence of cirrhosis and liver function) and the
characteristics of the virus (for example, genotype) are important when
assessing the chance of success and when choosing the best therapeutic
strategy (nucleoside/nucleotide analogue or interferon). Thirdly, during
therapy, the antiviral effect--assessed by decrease in HBV DNA
level--allows an individualized response-guided approach. In addition,
quantification of HBsAg after 3-6 months of interferon therapy appears to
be a good predictor of sustained virological response after treatment and
HBsAg clearance. Continuing interferon therapy until week 48 is justified
in patients with a significant decrease in HBsAg. Ongoing and future
studies will provide useful information regarding prolonging interferon
therapy beyond 48 weeks in some patients in order to increase efficacy,
and also regarding the role of combination therapy with interferon and
potent nucleoside/nucleotide analogues, such as entecavir or tenofovir
disoproxil fumarate.

PMID: 21041904 [PubMed - in process]

English to Chinese (Simplified) translation
Antivir。 2010年，15增刊3:53-9。

一个个性化的优化乙肝治疗
治疗初治患者。

Marcellin磷，梁j的

德Hépatologie服务，总医院Beaujon，美联社马力，克里希，法国。
patrick.marcellin @ bjn.aphp.fr

摘要
在慢性乙型肝炎，个性化的治疗初治患者
方法使治疗效果得到优化。首先，选择
为治疗好的候选人是至关重要的。例慢性活动
B型肝炎 - 相对较低的HBV DNA复制水平“（<10（9）
拷贝/毫升）和较高的丙氨酸转氨酶（ALT）水平 - 是
良好的治疗候选人。相比之下，慢性肝炎患者
乙方在免疫耐受阶段，谁拥有高水平的乙肝病毒DNA和
ALT水平持续正常，以及非活动性乙肝表面
抗原（HBsAg），乙肝病毒DNA和低ALT水平正常运营商并不
有迹象显示，他们对治疗反应较差。其次，
患者的特征（例如，性别，年龄，免疫状态，
一般健康状况和合并症），肝脏的特点
疾病（例如，肝硬化和肝功能的存在）和
该病毒的特征（例如，基因型）是重要的时
评估成功的机会和选择最佳的治疗时
战略（核苷/核苷酸类似物或干扰素）。第三，在
治疗中，抗病毒效果 - 以减少评估的HBV DNA
级别 - 允许个性化的反应引导的方法。此外，
乙肝表面抗原定量干扰素治疗后3-6个月出现
是一个持续的病毒学应答及治疗后的良好预测
HBsAg清除。一直持续到48周干扰素治疗是合理的
凭借在显着降低患者的乙肝表面抗原。目前和未来
研究将提供有用的信息关于延长干扰素
在一些患者超过48周治疗，以提高疗效，
并就结合干扰素治疗的作用，
强有力的核苷/核苷酸类似物，如恩替卡韦或替诺福韦
disoproxil富马酸。

结论：21041904 [PubMed的 - 过程]






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