慢性乙型肝炎患者管理（英文版）PPT.pptVIP

Roadmap for Management of Patients with Chronic Hepatitis B (CHB)Prof. Xinxin ZhangRui Jin HospitalJiao Tong University;Introduction Presentation Objectives Data Review: Associations of HBV DNA with Outcomes i. Natural history studies ii. Impact of treatment Key role of HBV DNA in On-Treatment Management i. Timing and magnitude of HBV DNA suppression On-Treatment Roadmap Concept Summary and Conclusions;IntroductionTreatment challenges highlight need for new management approach ;Presentation Objectives;Data Review: Associations of HBV DNA with Outcomes;Hepatocellular Carcinoma (HCC)Association with baseline HBV DNA: Taiwan natural history study ;Evidence for Association Between HBV DNA and Clinical Outcomes;Data Review: Associations of HBV DNA with Outcomes;Consistent relationship in treated and untreated patients HBV DNA could be used as a marker of efficacy;P0.001;Months;Viral Suppression Improves Outcomes Studies reporting associations with outcomes;Key Role of HBV DNA in On-Treatment Management;;Patients with HBV DNA 20,000 copies/mL at 72 weeks (%);Profound, Early Viral Suppression Week 24 viral load and 2-year outcomes? with telbivudine and lamivudine;Profound, Early Viral Suppression Week 24 viral load and 1-year outcomes with entecavir;;n=183;47/159;Profound, Early Viral Suppression Correlates with Lower Risk of Resistance;;HBeAg loss;On-Treatment Roadmap Concept;Potential Foundation for Building a CHB Therapeutic Roadmap;Unresolved questions What Is the best on-treatment marker? When Is the best timing for decision points? What Cut-off level for on-treatment decisions? Which Type of initial/add-on therapy?;Start treatment;Start treatment;Roadmap ConceptManagement algorithm for complete response at 24 weeks;Roadmap ConceptManagement algorithm for partial response at 24 weeks;Inadequate response ≥2000 IU/mL or ≥10,000 copies/mL;HBV Roadmap Proposal: Monitoring;Summary and ConclusionsImportance of early monitoring of virologic response