乙型肝炎病毒再激活.pptVIP

乙型肝炎病毒再激活: 一个能够预防的问题 南昌大学第一附属医院 张伦理 Thanks 预先抗病毒治疗的价值 HBsAg-positive patients with NHL treated with CHOP randomized to “preemptive” vs “on-demand” lamivudine Hsu C, et al. Hepatology. 2008;47:844-853. On-demand group: start LAM if ALT 1.5 x ULN Preemptive group: start LAM on Day 1 of CHOP Preemptive antivirals decrease HBV reactivation HBV Reactivation and Hepatitis Flare HBV Reactivationand Jaundice HBV Reactivation and ALT 10 x ULN Death (After ChemoTx) 100 80 60 40 20 0 HBsAg Patients (%) 48 8 36 0 20 0 0 8 如何选择抗病毒治疗方案与监测 治疗方案的选择受 HBV DNA 水平的影响 HBV DNA 2000 IU/mL: any