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转氨酶正常或低于正常值2倍以下慢性乙型肝炎病毒感染者治疗问题 被引量：7

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摘要 转氨酶正常或低于正常值2倍以下HBV感染者治疗问题已成为临床关注的热点。既往和更新版的国际、国内乙型肝炎相关指南对ALT正常或低于正常值2倍以下的HBV感染者,包括免疫耐受期、非活动性HBV携带者、非活动性HBsAg携带者因抗病毒治疗效果极差,故不予推荐抗病毒治疗。肝硬化患者,只要能检出HBVDNA,不论ALT或AST是否升高,应给予核苷(酸)类似物抗病毒治疗。笔者认为临床工作中对持续HBV DNA阳性,即使转氨酶正常或低于正常值2倍以下的HBV感染者,只要临床上有肝纤维化的证据,如影像学检查(B超、CT、MRI)提示脾脏肿大、血小板降低,其原因只能用HBV感染解释的,尤其对年龄在40岁以上或接近40岁年龄段的HBV感染者均应积极抗病毒治疗。慢性HBV携带者无需免疫治疗。本文还对慢性HBV携带者提出了若干建议,目的是普及乙型肝炎知识,提高认知程度,加强依从性教育。
作者 聂青和
机构地区 第四军医大学唐都医院感染病科/全军感染病诊治中心/国家重点学科
出处 《实用肝脏病杂志》 CAS 2013年第4期293-295,共3页 Journal of Practical Hepatology
关键词 慢性乙型肝炎 慢性HBV携带者 非活动性HBSAG携带者 抗病毒治疗 免疫治疗 丙氨酸氨基转 移酶 健康教育
分类号 R512.62 [医药卫生—内科学]
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参考文献19

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二级参考文献9

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实用肝脏病杂志
2013年 第4期

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