多重耐药HBV感染特点及挽救治疗策略.PDFVIP

传染病信息  2017年4月30日  第30卷  第2期  Infect Dis Info, Vol. 30, No. 2, April 30, 2017  ·109· ·综　　述· 多重耐药HBV 感染特点及挽救治疗策略 周　怡，刘　妍，徐东平，刘　敏     [摘要]　多重耐药 HBV 感染的治疗是临床面临的一个难题。多重耐药的发生主要与病毒因素、宿主因素和药物因素等 相关。严格评估抗病毒治疗指征，初治选择高耐药基因屏障的抗病毒药物，避免以低耐药基因屏障药物起始的单药序贯治疗 等措施能够降低多重耐药 HBV 株产生的风险。对于已发生耐药与多重耐药 HBV 感染的患者，应尽早开始挽救性治疗。有 多项研究提示恩替卡韦与替诺福韦酯联合是针对难治性多重耐药 HBV 感染的更加有效、安全的挽救性治疗方案。研究开发 多靶点作用的新型抗病毒药物是治疗多重耐药 HBV 感染的新途径。     [关键词]　乙型肝炎病毒；多重耐药；抗病毒药物；挽救治疗     [中国图书资料分类号] R978.1；R512.6　　　　[文献标志码]　A　　　　[文章编号] 1007-8134(2017)02-0109-06　   　　DOI:10.3969/j.issn.1007-8134.2017.02.011 Characteristics and rescue therapy strategies of multidrug-resistant HBV infection * * ZHOU Yi, LIU Yan , XU Dong-ping, LIU Min 　　 ´ Department of Infectious Diseases, The First Affiliated Hospital of Xi an Jiaotong University, 710061, China 　　*Corresponding authors. LIU Yan, E-mail: liuyan5360@163.com; LIU Min, E-mail: liumin3262@126.com 　　[Abstract]　Multidrug-resistant HBV infection is a great challenge to the antiviral therapy in clinic. The development of multidrug-resistant HBV is associated with virus factors, host factors and drug factors. Strict evaluation on the treatment indications, choosing nucleos(t)ide analogues with a higher drug-resistant genetic barrier in initial treatment regimen and avoiding sequential mono- therapy starting with a lower drug-resistant genetic barrier drug can reduce the risk of developing multidrug-resistant HBV strain. Rescue therapy should be taken as early as possible for patients who have already developed the drug-resistant and multidrug-resistant virus infection. Recently, increasing evidence suggest that combination of entecavir and te