不同抗病毒药物降低HBV相关肝细胞癌风险的作用

吴丽贤; 郑伟强; 韩焕钦

doi:10.3969/j.issn.1001-5256.2022.05.040

不同抗病毒药物降低HBV相关肝细胞癌风险的作用

DOI: 10.3969/j.issn.1001-5256.2022.05.040

广东医科大学附属医院感染内科，广东湛江 524001

基金项目:

广东省自然科学基金面上项目 (2021A1515011589);

广东医科大学附属医院临床研究资助项目 (LCYJ2020B001)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：吴丽贤负责收集、分析资料，撰写综述; 郑伟强负责综述内容设计; 韩焕钦负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
郑伟强，zwqgd@sina.com

韩焕钦，huanqinhan@126.com

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出版历程
- 收稿日期: 2021-11-03
- 出版日期: 2022-05-20

Effect of different antiviral drugs in reducing the risk of hepatitis B virus-related hepatocellular carcinoma

Department of Infectious Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong 524001, China

Research funding:

Guangdong Basic and Applied Basic Research Foundation (2021A1515011589);

Clinical Research Project of Affiliated Hospital of Guangdong Medical University (LCYJ2020B001)

More Information

Corresponding author: ZHENG Weiqiang, zwqgd@sina.com(ORCID: 0000-0002-6979-2283); HAN Huanqin, huanqinhan@126.com(ORCID: 0000-0002-2333-1561)

摘要

摘要: 抗病毒治疗可降低慢性乙型肝炎患者肝细胞癌(HCC)发生的风险。在一线抗病毒药物中，更多的研究显示富马酸替诺福韦酯降低HCC风险的作用可能优于恩替卡韦，尤其在亚裔患者当中; 极有限的研究表明富马酸丙酚替诺福韦酯降HCC风险的作用可能优于富马酸替诺福韦酯; IFN降HCC风险的效果优于单用核苷(酸)类似物。现有可及的药物中，IFN联合核苷(酸)类似物或是HCC高风险患者降低HCC风险的最佳选择。但上述不同药物降HCC风险作用的比较，循证证据级别偏弱，均有赖于随机对照研究进一步阐明。临床实践中，需根据患者实际情形、基础情况，权衡患者HCC发生风险、对药物的耐受性和经济的可承受性，制订个体化的抗病毒策略。
- 乙型肝炎病毒 /
- 癌，肝细胞 /
- 抗病毒药
Abstract: Antiviral therapy can reduce the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B. As for the first-line antiviral drugs, more studies have shown that tenofovir disoproxil fumarate may be better than entecavir in reducing the risk of HCC, especially among Asian patients; a limited number of studies have shown that tenofovir alafenamide fumarate may be better than tenofovir disoproxil fumarate in reducing the risk of HCC; interferon has a better effect than nucleos(t)ide analogues alone in reducing the risk of HCC. Among the currently available drugs, interferon combined with nucleos(t)ide analogues may be the best choice to reduce the risk of HCC in patients at a high risk of HCC. The level of evidence-based medicine is weak for comparing the effect of different drugs in reducing the risk of HCC, and randomized controlled trials are needed for further clarification. In practice, it is necessary to weigh the risk of HCC, drug tolerance and economic affordability based on the patient's basic conditions and actual situations, so as to develop individualized anti-viral strategies.
- Hepatitis B virus /
- Carcinoma, Hepatocellular /
- Antiviral Agents

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参考文献(39)

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