乙型肝炎肝硬化抗病毒治疗研究进展

摘要

Chronic hepatitis B virus (HBV) infection is one of the major global public health problems. Every year,about 3% of the chronic hepatitis B patients develop cirrhosis. Without efficient anti-viral treatment, these patients may develop decompensated cirrhosis or hepatocellular carcinoma (HCC). Antiviral treatment, including interferon (IFN) and nucleos (t) ide analogues (NUCs) is important in the cirrhotic patients. IFN can suppress HBV replication and mediate the immunologic function with considerable side effects. It can only be used in well-compensated cirrhosis. NUCs include lamivudine (LAM) , adefovir dipivoxil ( ADV) , enteccavir (ETV) , telbivudine (TEB) and tenofovir disoproxil fumarate ( TDF). They can suppress HBV replication and reduce the long-term complications. They have fewer side effects, but are easy to develop drug resisitance. This review focused on the recent progress in the antiviral treatment of HBV-related cirrhosis.%慢性乙肝病毒感染是全世界主要的公共卫生问题之一,每年有约3％的慢性乙型肝炎患者发展为肝硬化.若无有效的抗病毒治疗手段,这些乙肝患者会发展为失代偿期肝硬化或肝细胞癌.对于肝硬化患者,干扰素(interferon,IFN)和核苷类似物[nucleos(t)ide analogues,NUCs]是重要的抗病毒药物.IFN能抑制乙肝病毒复制并调节免疫功能,但不良反应较大,仅可用于情况较好的代偿期肝硬化患者；NUCs包括拉米夫定、阿德福韦酯、恩替卡韦、替比夫定及替诺福韦酯,能够抑制病毒复制,减少肝硬化患者远期并发症的发生,不良反应小但容易发生病毒耐药.本文对乙肝肝硬化的抗病毒治疗新进展作一综述.