核苷(酸)类似物抗病毒治疗预防乙型肝炎病毒相关肝细胞癌:治疗时机及药物选择
Timing and selection of antiviral therapy with nucleos(t)ide analogues for prevention of hepatitis B virus -related HCC
乙型肝炎病毒(HBV)感染是导致我国肝细胞癌(HCC)的最主要原因,长期有效的抗病毒治疗可以明显降低HCC的发生.强效、高耐药基因屏障核苷(酸)类似物(NAs)包括恩替卡韦和替诺福韦在临床上广泛使用以来,慢性乙型肝炎患者血清中HBV DNA检测不出率超过85% ~ 95%,但少数患者仍然可以发生HCC.现将对NAs治疗的时机和选择NAs的种类在预防和降低HCC发生率上是否不同等问题做一综述.
更多Hepatitis B virus (HBV) infection is a leading cause of hepatocellular carcinoma (HCC) in China.The occurrence of HCC can significantly be reduced with effective long-term antiviral treatment.Since the widespread clinical use of nucleos(t)ide analogues,such as entecavir and tenofovir that has a strong potency and high genetic barrier to resistance;the detection rate of HBV DNA in serum of patients with chronic hepatitis B is no more than 85% ~ 95%,but HCC can still occur in a small number of patients.This article will review whether the timing and selection of NAs treatment differ to prevent and reduce the incidence of HCC.
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