【新整理】慢性乙型肝炎患者管理(英文版)(編輯修改稿)
2024-11-19 00:18 本頁面
【文章內(nèi)容簡介】 fing Document 2005,20,HBeAg seroconversion occurred only in this group,Weeks,Median HBV DNA, log10 copies/mL,Potential assessment of early virological response to predict outcome,Gauthier et al 1999,Magnitude of Viral Response to Lamivudine Association with higher rates of HBeAg seroconversion,21,n=183,n=54,n=81,n=107,Seroconversion at 2 years, %,Serum HBV DNA level at 24 weeks, log10 copies/mL,Early Viral Suppression with Telbivudine Association with 2year HBeAg seroconversion?,HBeAgpositive patients,Han et al 2007,?Preliminary data from locked database,22,47/159,8/34,14/117,2/15,Seroconversion at 48 weeks, %,HBV DNA at 24 weeks, copies/mL,HBeAgpositive patients,BMS Entecavir AVDAC Briefing Document 2005,Early Viral Suppression with Entecavir Association with 1year HBeAg seroconversion?,23,Profound, Early Viral Suppression Correlates with Lower Risk of Resistance,Hadziyannis et al 2006。 Yuen et al 2001,Patients with lamivudine resistance , %,HBeAgpositive patients (n=159), median 30 months follow up,HBV DNA level at week 24, copies/mL,1/12,3/23,13/41,76/118,Patients with ADV resistance at week 192, %,HBeAgnegative patients (n=125),HBV DNA level at week 48, copies/mL,24,HBeAgnegative patients,Patients with telbivudine resistance week 92, %,n=178,n=16,n=18,n=10,Di Bisceglie et al 2006,Early Viral Suppression with Telbivudine Association with resistance?,?Preliminary analysis of patients with viral rebound at week 92,HBV DNA level at week 24, copies/mL,≤300,300–3 log10,3 log10–4 log10,5 log10,25,HBeAgpositive,HBeAgnegative,Goals of HBV therapy Prevent cirrhosis, liver failure and HCC Improve survival,Signpost,Signpost,Early Viral Suppression Can Be a Signpost for Future Therapeutic Response,Start Rx.,OnTreatment Roadmap Concept,27,Potential Foundation for Building a CHB Therapeutic Roadmap,Ontreatnent early virological response monitoring Can help to identify suboptimal responders Provides opportunities to modify treatment to enhance antiviral efficacy Can help support individualised treatment maps Has the potential to improve longterm outcomes,Response markers act as signposts for clinical management,28,Unresolved questions What Is the best ontreatment marker? When Is the best timing for decision points? What Cutoff level for ontreatment decisions? Which Type of initial/addon therapy?,? ?,?,Expert panel convened to evaluate evidence and develop treatment recommendations,Report of an International Workshop: Roadmap for Management of Patients Receiving Oral Therapy for Chronic Hepatitis B Keeffe EB et al. Clinical Gastroenterology and Hepatology 2007,Proposed New Treatment Algorithm for CHB Recent expert panel and Roadmap publication,Keeffe et al 2007,29,Start treatment,≥1 log 10 copies/mL
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