HIV感染者中慢性乙型肝炎病毒感染的治疗前评估
- Authors
- Kenneth E Sherman, MD, PhD
Kenneth E Sherman, MD, PhD
- Professor of Medicine
- University of Cincinnati College of Medicine
- Chloe L Thio, MD
Chloe L Thio, MD
- Professor of Medicine
- Johns Hopkins University
- Section Editor
- David L Thomas, MD
David L Thomas, MD
- Section Editor — Hepatitis/HIV Coinfection
- Chief, Division of Infectious Diseases
- Johns Hopkins University School of Medicine
- Deputy Editor
- Jennifer Mitty, MD, MPH
Jennifer Mitty, MD, MPH
- Deputy Editor — Infectious Diseases
- Translators
- 尹华发, 主任医师
尹华发, 主任医师
- 安徽医科大学第一附属医院感染病科
引言
强效抗逆转录病毒治疗(antiretroviral therapy, ART)的广泛应用已使机会性感染的发生率下降，并产生了一个新的关注点，即导致并发症[如继发于慢性乙型肝炎病毒(hepatitis B virus, HBV)感染的终末期肝病]的其他主要原因[1]。
人类免疫缺陷病毒(human immunodeficiency virus, HIV)的治疗指南一般推荐对所有HIV感染者的HBV感染都进行治疗，无论其CD4细胞计数如何[2-5]。对于HIV/HBV共感染者，ART应包括对HIV和HBV具有双重活性的药物。
HIV感染者中HBV的治疗前评估将总结在此，HIV感染者中HBV感染的流行病学、临床表现、诊断、治疗和预防将单独讨论。 (参见“HIV感染者中乙型肝炎的流行病学、临床表现和诊断”和“艾滋病病毒感染者慢性乙型肝炎的治疗”和“HIV感染成人的乙型肝炎病毒感染预防”)
评估方法
对于大多数慢性HBV感染的HIV感染者，无论其肝病分期或免疫抑制水平(即，CD4细胞计数)如何，都将对其HIV和HBV进行治疗。 (参见“艾滋病病毒感染者慢性乙型肝炎的治疗”，关于‘确定哪些患者需要治疗’一节)
这类患者的治疗前评估包括：获取疾病活动度的基线标志物水平用于监测治疗反应、获取用于决定使用哪种抗病毒药物来治疗HBV的信息，以及获取用于评估肝损伤其他病因和晚期肝病并发症[如，静脉曲张、肝细胞癌(hepatocellular carcinoma, HCC)]的信息。
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To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-06 . | This topic last updated: 2015-03-23.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- Weber R, Sabin CA, Friis-Møller N, et al. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med 2006; 166:1632.
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- European guidelines for treatment of HIV-infected adults. http://www.eacsociety.org/guidelines/eacs-guidelines/eacs-guidelines.html (Accessed on January 14, 2015).
- World Health Organization. Guidelines for the prevention, care and treatment of persons living with chronic hepatitis B http://apps.who.int/iris/bitstream/10665/154590/1/9789241549059_eng.pdf?ua=1 (Accessed on March 23, 2015).
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