抗病毒治疗是病毒性疾病治疗的基石,只有彻底清除病毒才能阻止疾病的进展,改善临床结局。
在慢性乙型肝炎(CHB)的管理上,抗病毒治疗同样有着非常重要的地位。什么时候开启抗病毒治疗,哪些患者需要抗病毒治疗,都是广大医生们所关注的话题。其中关于免疫耐受期(IT-CHB)患者是否应接受抗病毒治疗,一直争议不断,堪称CHB治疗的“灰色地带”。
IT-CHB患者以病毒水平高、谷丙转氨酶(ALT)正常、HBeAg阳性、无肝脏损伤或伴轻微肝脏损伤为特征[1]。
临床上,医生也总是被这部分患者问道:“我的病毒水平这么高,为什么不治疗呢?不治疗,会不会得肝癌呢?”
其实对于这部分患者来说,治,或者不治,一直是众多学者们争论的焦点,也是学术界持续争议的话题。今天我们就结合近期发表的一些文章,一起对这当中的疑惑、困难、和见解进行探讨。
四种假设
仍有不少问题尚待商榷
参考文献:
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