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首页> 外文期刊>Journal of Global Health >Combination Therapy for Chronic Hepatitis B: Current Updates and Perspectives
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Combination Therapy for Chronic Hepatitis B: Current Updates and Perspectives

机译:慢性乙型肝炎联合治疗:最新动态和观点

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Nucleos(t)ide analogues (NUCs) and interferon have been used for several decades to treat chronic hepatitis B; however, the therapeutic response remains unsatisfactory. Although NUC therapy exhibits potent on-treatment viral suppression, frequent off-therapy virological relapses suggest an indefinite treatment course. Interferon modulates the innate and adaptive antiviral immune responses and thus increases the chance of viral eradication. Interferon therapy has the advantage of a finite duration, absence of drug resistance, and durable posttreatment responses. Therefore, the combination of NUCs and interferon can theoretically facilitate a synergistic therapeutic effect. This paper summarizes the current strategies of various combination therapies into three categories: the simultaneous “dual” strategy, sequential combination “add-on” strategy, and “switch” strategy. Generally, dual therapy exhibits greater on-treatment and off-therapy viral suppression and lower drug resistance compared with NUC monotherapy. Compared with interferon monotherapy, dual therapy has greater on-treatment viral suppression but shows no difference in off-therapy sustained virological responses. Specific add-on or switch strategies provide promising on-treatment efficacy in select patients. Pretreatment or on-treatment quantitative hepatitis B surface antigen and e antigen are predictive for the treatment efficacy of combination therapy. The optimal schedule of combination regimens and individualized therapy remain to be comprehensively evaluated.Keywords: Nucleos(t)ide analogue, Interferons, Dual, Add-on, Switch
机译:核苷酸类似物(NUCs)和干扰素已用于治疗慢性乙型肝炎已有数十年之久。然而,治疗反应仍然不令人满意。尽管NUC治疗表现出有效的治疗中病毒抑制作用,但频繁的非治疗性病毒学复发提示治疗过程不确定。干扰素调节先天性和适应性抗病毒免疫反应,从而增加了根除病毒的机会。干扰素治疗的优点是持续时间有限,没有耐药性和持久的治疗后反应。因此,NUC和干扰素的组合理论上可以促进协同治疗作用。本文将当前各种组合疗法的策略分为三类:同时“双重”策略,顺序组合“附加”策略和“转换”策略。通常,与NUC单一疗法相比,双重疗法表现出更大的治疗中和非疗法中病毒抑制和更低的耐药性。与干扰素单药治疗相比,双重疗法在治疗中对病毒的抑制作用更大,但在治疗后持续的病毒学应答方面无差异。特定的附加或转换策略可在某些患者中提供有希望的治疗效果。预处理或治疗中定量的乙肝表面抗原和e抗原可预测联合治疗的疗效。联合治疗方案和个体化治疗的最佳方案还有待全面评估。关键词:核苷类似物,干扰素,双重,附加,转换

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