《2004GPAC慢性乙型肝炎的临床管理》内容预览

Treatment should be given by a physician with expertise in hepatitis.
Notes: As ALT, serology and nucleic acid tests are imperfect markers, a liver biopsy is strongly indicated before treatment is initiated.
Treatment with interferon for 16 weeks will lead to an antiviral response in 25 to 30 per cent of individuals. Treatment with lamivudine for a year or more will lead to an antiviral response in 15 to 40 per cent of individuals. Prolonged therapy increases the risk of antiviral resistance.
What constitutes a hepatitis B antiviral response is complicated because of viral variability in patients and variability in the interpretation of the different available tests, e.g. ALT, HBsAg, HBeAg, HBV DNA. Treatment protocols for chronic hepatitis B are constantly evolving. A recent document on the management of viral hepatitis is available at:http://www.hepatology.ca/cm/FileLib/ViralHepatitisCanadianConsensus2004.pdf

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