《2016+EASL临床指南+慢性乙型肝炎病毒感染的管理》.pdfVIP

Clinical Practice Guidelines EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection European Association for the Study of the Liver⇑ Introduction been increasing over the last decade as a result of aging of the HBV-infected population and predominance of specific HBV Our understanding of the natural history of hepatitis B virus genotypes and represents the majority of cases in many areas, (HBV) infection and the potential for therapy of the resultant dis- including Europe [4,9,10]. Morbidity and mortality in CHB are ease is continuously improving. New data have become available linked to persistence of viral replication and evolution to cirrhosis since the previous EASL Clinical Practice Guidelines (CPGs) pre- and/or hepatocellular carcinoma (HCC). Longitudinal studies of pared in 2008 and published in early 2009 [1]. The objective of untreated patients with CHB indicate that, after diagnosis, the this manuscript is to update the recommendations for the opti- 5-year cumulative incidence of developing cirrhosis ranges mal management of chronic HBV infection. The CPGs do not fully from 8% to 20%. The 5-year cumulative incidence of hepatic address prevention including vaccination. In addition, despite the decompensation is approximately 20% for untreated patients increasing knowledge, areas of uncertainty still exist and there- with compensated cirrhosis [2–