Can antiviral therapy of chronic hepatitis B prevent the development of hepatocellular carcinoma?

摘要

The evolution of liver disease caused by chronic viral hepatitis, in particular the development of cirrhosis and hepatocel-lular carcinoma (HCC), is slow. As a consequence, clinicians have sought short-term, surrogate markers of disease progression as measures of treatment response. In chronic hepatitis B virus (HBV) infection, suppression of serum HBV DNA below limits of detection and/or hepatitis B '?antigen (HBeAg) seroconversion have become the immediate goals of therapy. However, the pursuit of these treatment goals should not detract from the real treatment aims-the prevention of premature mortality from liver disease and/or the cure of chronic infection indicated by permanent hepatitis B surface antigen (HBsAg) seroconversion. Lying between these extremes in the hierarchy of goals would be the prevention of histological or clinical disease progression and, for patients with advanced disease, the induction of disease regression.