派罗欣在慢乙肝持久免疫控制中及价值.ppt

派罗欣个性化治疗策略 —HBeAg阳性CHB 派罗欣治疗对象的选择 在有抗病毒指征的患者中 相对年轻的患者（包括青少年患者） 希望近年内生育的患者 期望短期完成治疗的患者 初次接受抗病毒治疗的患者 机体免疫反应较强的患者（如病毒载量较低、ALT水平较高、肝脏炎性反应程度较重）等 符合上述条件者，可优先推荐派罗欣治疗 派罗欣取得HBeAg转换2/3的病人发生在24周之后 派罗欣治疗过程中不良反应明确 派罗欣得到国家卫生主管部门的认可 2009年底，派罗欣已进入国家基本医疗保险目录（乙肝适应症） 目前已有18个省将派罗欣乙肝适应症列入省级医保目录 至2010年底，派罗欣乙肝适应症将陆续被全国其他各省纳入省级医保目录 参考文献索引： Buster et al. Sustained HBeAg and HBsAg loss after long-term follow-up of HBeAg-positive patients treated with peginterferon alpha-2b. Gastroenterology 2008 ;135(2):459-67. Chang et al. Results of up to 2 years of entecavir vs lamivudine therapy in nucleoside-na?ve HBeAg-positive patients with chronic hepatitis B.J Viral Hepat 2009 ;16(11):784-9. Cooksley et al. EASL 2005 (P24) Cooksley et al. Shanghai Hong Kong International Liver Congress 2006 (P25) Ferrari C et al. Cellular immune response to hepatitis B virus-encoded antigens in acute and chronic hepatitis B virus infection. J Immunol. 1990 ;145(10):3442-9. Hoofnagle et al. Management of hepatitis B: summary of a clinical research workshop. Hepatology 2007 ;45(4):1056-75. Janssen et al. Pegylated interferon alfa-2b alone or in combination with lamivudine for HBeAg-positive chronic hepatitis B: a randomised trial. Lancet 2005 ;365(9454):123-9. Jia JD, et al.Two-year results of a phase Ⅲ comparative trial of telbivudine vs lamivudine in Chinese patients. J Hepatology.2007: 46(Suppl 1):S189. Jung C et al. Virus-specific lymphokine production differs quantitatively but not qualitatively in acute and chronic hepatitis B infection. Virology 1999 ;261(2):165-72. Jurrien G.P,et al. Nucleos(t)ide Analogues Only Induce Temporary Hepatitis B e Antigen Seroconversion in Most Patients with Chronic Hepatitis B .Gastroenterology.2010.03.059. 参考文献索引 Lau et al. Peginterferon Alfa-2a, lamivudine, and the combination for HBeAg-positive chronic hepatitis B. N Engl J Med 2005; 352(26):2682-95. Lau et al. Durability of response and occurrence of late response to Peginterferon alfa-2a(40KD)[PEGASYS]