干扰素与核苷和核苷酸类药物联合或序贯治疗慢性乙型肝炎方案的探讨

摘要

Currently,there are two categories of antiviral drugs used for chronic hepatitis B (CHB):interferons (IFNs)and nucleos(t)ide analogues (NAs).IFNs showed lower efficacy and more adverse effects,although they achieved some anti -HBV results.NAs showed stronger antiviral activity and a lower incidence rate of adverse effects;however,there are also some problems,such as high risk of relapse after the NAs are discontinued and increased rate of drug resistance with a longer course of treatment.Therefore,it is very important for cli-nicians to investigate the optimal therapy against HBV to further improve efficacy and safety in the treatment of CHB.In this paper,the re-search on combination therapy and sequential therapy against HBV is reviewed,in the hope that clinicians may have a deeper knowledge of combination therapy and sequential therapy against HBV,so as to provide more choices for antiviral therapy of CHB patients.%目前用于慢性乙型肝炎（CHB）抗病毒治疗的药物有干扰素（IFN）与核苷和核苷酸类药物（NAs）两大类。IFN在抗HBV方面虽取得了一定的效果，但抗病毒作用有限，且不良反应较大；NAs抗病毒作用强、不良反应发生率低，但也存在一些问题，如停药后易复发、随着疗程延长产生耐药的趋势增加等。因此，探索抗病毒药物的优化治疗方案，进一步提高CHB抗病毒治疗的有效性和安全性对临床医生而言具有十分重要的意义。就近年来国内外对两类药物联合或序贯治疗的研究进展进行阐述，使临床医生对抗HBV的联合或序贯治疗有更加深入的了解，为CHB患者的抗病毒治疗提供更多选择。