中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 6
Jun.  2023
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(6): 1299-1303

Evolution in the indications for anti-viral therapy in chronic hepatitis B

DOI: 10.3969/j.issn.1001-5256.2023.06.007

  • Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Research funding:

Beijing Municipal Science & Technology Commission (Z221100007422115)

More Information
  • Corresponding author: YOU Hong, youhong30@sina.com (ORCID: 0000-0001-9409-1158)
  • Received Date: 2023-04-01
  • Accepted Date: 2023-05-01
  • Published Date: 2023-06-20
    Abstract
  • In order to reduce the disease burden of chronic hepatitis B (CHB) and improve the treatment rate of CHB, the indications for anti-viral therapy have been gradually expanded and simplified in guidelines for the prevention and treatment of CHB released by Chinese Medical Association from 2005 to 2022. This article elaborates on the evolution in the indications for anti-viral therapy in CHB from the five aspects of converging indications of HBeAg-positive and HBeAg-negative CHB, reduction in the treatment threshold of HBV DNA, reduction in the treatment threshold of serum alanine aminotransferase, emphasis on the risk factors for disease progression, and gradual loosening of the requirements for virological indicators in patients with liver cirrhosis.

     

    • FullText(HTML)
  • loading
    • References(30)
  • [1]
    Polaris observatory HBV collaborators[EB/OL]. [2022-11-10]. http://cdafound.org/dashboard/polaris/dashboard.html.
    [2]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B[J]. J Clin Hepatol, 2006, 22(1): 3-15. http://lcgdbzz.org/article/id/LCGD200601000

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南[J]. 临床肝胆病杂志, 2006, 22(1): 3-15. http://lcgdbzz.org/article/id/LCGD200601000
    [3]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J]. J Clin Hepatol, 2011, 27(1): 113-128. http://lcgdbzz.org/article/id/LCGD201101035

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2010年版)[J]. 临床肝胆病杂志, 2011, 27(1): 113-128. http://lcgdbzz.org/article/id/LCGD201101035
    [4]
    Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B: a 2015 update[J]. J Clin Hepatol, 2015, 31(12): 1941-1960. DOI: 10.3969/j.issn.1001-5256.2015.12.002.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2015年更新版)[J]. 临床肝胆病杂志, 2015, 31(12): 1941-1960. DOI: 10.3969/j.issn.1001-5256.2015.12.002.
    [5]
    Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
    [6]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association; Guidelines for the prevention and treatment of chronic hepatitis B (2022 version)[J]. Chin J Infect Dis, 2023, 41(1): 3-28. DOI: 10.3760/cma.j.cn311365-20230220-00050.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2022年版)[J]. 中华传染病杂志, 2023, 41(1): 3-28. DOI: 10.3760/cma.j.cn311365-20230220-00050.
    [7]
    YENILMEZ E, ÇETINKAYA RA, TURAL E. Diagnostic dilemma for low viremia with significant fibrosis; is hepatitis B virus DNA threshold level a good indicator for predicting liver damage?[J]. Balkan Med J, 2018, 35(4): 326-332. DOI: 10.4274/balkanmedj.2017.0888.
    [8]
    JENG WJ, PAPATHEODORIDIS GV, LOK A. Hepatitis B[J]. Lancet, 2023, 401(10381): 1039-1052. DOI: 10.1016/S0140-6736(22)01468-4.
    [9]
    ZHANG Q, PENG H, LIU X, et al. Chronic hepatitis B infection with low level viremia correlates with the progression of the liver disease[J]. J Clin Transl Hepatol, 2021, 9(6): 850-859. DOI: 10.14218/JCTH.2021.00046.
    [10]
    LEE MH, YANG HI, LIU J, et al. Prediction models of long-term cirrhosis and hepatocellular carcinoma risk in chronic hepatitis B patients: risk scores integrating host and virus profiles[J]. Hepatology, 2013, 58(2): 546-554. DOI: 10.1002/hep.26385.
    [11]
    ZHAO Q, LIU K, ZHU X, et al. Anti-viral effect in chronic hepatitis B patients with normal or mildly elevated alanine aminotransferase[J]. Antiviral Res, 2020, 184: 104953. DOI: 10.1016/j.antiviral.2020.104953.
    [12]
    SHANG H, CHEN WX, PAN BS, et al. Reference intervals for common tests of liver function, electrolytes and blood cell analysis of Chinese adults[J]. Chin J Lab Med, 2013, 36(5): 393-394. DOI: 10.3760/cma.j.issn.1009-9158.2013.05.003.

    尚红, 陈文祥, 潘柏申, 等. 中国成人常用肝功能和电解质及血细胞分析项目参考区间[J]. 中华检验医学杂志, 2013, 36(5): 393-394. DOI: 10.3760/cma.j.issn.1009-9158.2013.05.003.
    [13]
    WU Z, MA AL, XIE Q, et al. Significant histological changes and satisfying antiviral efficacy in chronic hepatitis B virus infection patients with normal alanine aminotransferase. Antiviral therapy decision in chronic HBV patients with normal ALT[J]. Clin Res Hepatol Gastroenterol, 2021, 45(2): 101463. DOI: 10.1016/j.clinre.2020.05.011.
    [14]
    DUAN M, CHI X, XIAO H, et al. High-normal alanine aminotransferase is an indicator for liver histopathology in HBeAg-negative chronic hepatitis B[J]. Hepatol Int, 2021, 15(2): 318-327. DOI: 10.1007/s12072-021-10153-2.
    [15]
    KAO JH, HU TH, JIA J, et al. East Asia expert opinion on treatment initiation for chronic hepatitis B[J]. Aliment Pharmacol Ther, 2020, 52(10): 1540-1550. DOI: 10.1111/apt.16097.
    [16]
    SARRI G, WESTBY M, BERMINGHAM S, et al. Diagnosis and management of chronic hepatitis B in children, young people, and adults: summary of NICE guidance[J]. BMJ, 2013, 346: f3893. DOI: 10.1136/bmj.f3893.
    [17]
    TERRAULT NA, BZOWEJ NH, CHANG KM, et al. AASLD guidelines for treatment of chronic hepatitis B[J]. Hepatology, 2016, 63(1): 261-283. DOI: 10.1002/hep.28156.
    [18]
    Chinese Society of Infectious Diseases, Chinese Medical Association. Expert opinion on expanding anti-HBV treatment for chronic hepatitis B[J]. Chin J Hepatol, 2022, 30(2): 131-136. DOI: 10.3760/cma.j.cn501113-20220209-00060.

    中华医学会肝病学分会. 扩大慢性乙型肝炎抗病毒治疗的专家意见[J]. 中华肝脏病杂志, 2022, 30(2): 131-136. DOI: 10.3760/cma.j.cn501113-20220209-00060.
    [19]
    WANG H, SHAN S, YOU H, et al. Effect of the change in antiviral therapy indication in increasing the treatment rate of chronic hepatitis B[J]. J Clin Hepatol, 2022, 38(6): 1269-1274. DOI: 10.3969/j.issn.1001-5256.2022.06.011.

    王皓, 单姗, 尤红, 等. 抗病毒治疗适应证变化对提高慢性乙型肝炎治疗率的影响[J]. 临床肝胆病杂志, 2022, 38(6): 1269-1274. DOI: 10.3969/j.issn.1001-5256.2022.06.011.
    [20]
    ZHANG S, WANG C, LIU B, et al. Cost-effectiveness of expanded antiviral treatment for chronic hepatitis B virus infection in China: an economic evaluation[J]. Lancet Reg Health West Pac, 2023: 100738. DOI: https://doi.org/ 10.1016/j.lanwpc.2023.100738.
    [21]
    SARIN SK, KUMAR M, LAU GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update[J]. Hepatol Int, 2016, 10(1): 1-98. DOI: 10.1007/s12072-015-9675-4.
    [22]
    TERRAULT NA, LOK A, MCMAHON BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance[J]. Hepatology, 2018, 67(4): 1560-1599. DOI: 10.1002/hep.29800.
    [23]
    SUN Y, CHANG J, LIU X, et al. Mortality trends of liver diseases in mainland China over three decades: an age-period-cohort analysis[J]. BMJ Open, 2019, 9(11): e029793. DOI: 10.1136/bmjopen-2019-029793.
    [24]
    YAO K, LIU J, WANG J, et al. Distribution and clinical characteristics of patients with chronic hepatitis B virus infection in the grey zone[J]. J Viral Hepat, 2021, 28(7): 1025-1033. DOI: 10.1111/jvh.13511.
    [25]
    CHAYANUPATKUL M, OMINO R, MITTAL S, et al. Hepatocellular carcinoma in the absence of cirrhosis in patients with chronic hepatitis B virus infection[J]. J Hepatol, 2017, 66(2): 355-362. DOI: 10.1016/j.jhep.2016.09.013.
    [26]
    Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Consensus on clinical application of transient elastography detecting liver fibrosis: a 2018 update[J]. Chin J Hepatol, 2019, 27(3): 182-191. DOI: 10.3760/cma.j.issn.1007-3418.2019.03.004.

    中华医学会感染病学分会, 中华医学会肝病学分会. 瞬时弹性成像技术诊断肝纤维化专家共识(2018年更新版)[J]. 中华肝脏病杂志, 2019, 27(3): 182-191. DOI: 10.3760/cma.j.issn.1007-3418.2019.03.004.
    [27]
    SINN DH, KIM SE, KIM BK, et al. The risk of hepatocellular carcinoma among chronic hepatitis B virus-infected patients outside current treatment criteria[J]. J Viral Hepat, 2019, 26(12): 1465-1472. DOI: 10.1111/jvh.13185.
    [28]
    ALSHUWAYKH O, DAUGHERTY T, CHEUNG A, et al. Incidence of hepatocellular carcinoma in chronic hepatitis B virus infection in those not meeting criteria for antiviral therapy[J]. Hepatol Commun, 2022, 6(11): 3052-3061. DOI: 10.1002/hep4.2064.
    [29]
    RAZAVI-SHEARER D, ESTES C, GAMKRELIDZE I, et al. Cost-effectiveness analysis of treating all HBsAg plus individuals in the United States[J]. Hepatology, 2021, 74(Suppl 1): 30A. DOI: 10.1002/hep.32187.
    [30]
    WONG RJ, KAUFMAN HW, NILES JK, et al. Simplifying treatment criteria in chronic hepatitis B: Reducing barriers to elimination[J]. Clin Infect Dis, 2023, 76(3): e791-e800. DOI: 10.1093/cid/ciac385.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (515) PDF downloads(191) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return