慢乙肝患者如何合理使用抗病毒药物短版.pptVIP

* 抗病毒治疗中监测和管理什么？ 全过程管理： 监测的过程就是管理的过程 依从性是管理的最重要部分 拒绝喝酒、反对超重、谨慎用药、适当营养、排斥“毒品”、适量运动 定期定时复查： 每月一次？ 每三个月一次？ 每半年一次？ * 总 结 我们有理由乐观地对待慢性乙型肝炎 抗病毒治疗是关键，有适应证就必须抗病毒 初始选药是治疗成功的关键 个体化用药是合理治疗的内核 正确对待和处理抗病毒治疗面临的问题 多沟通多交流，使我们更“合理” 事实将证明：明天会更好！ * 欢迎您访问我的个人网站 所有资料24小时阅读，阅读一定能改变您 咨询室每天限号10人，我的可用时间有限 非信莫入！ * * * 强调医源性传播。 * * * The cumulative incidence of liver cirrhosis over time increased with increasing baseline HBV DNA levels: high viral load is associated with increased incidence of cirrhosis. The figure on this slide shows the cumulative incidence of cirrhosis in the R.E.V.E.A.L.-HBV study. The cumulative incidence rates were calculated for different categories of serum HBV DNA level using the Nelson–Aalen method, a nonparametric method for estimating the cumulative hazard. The cumulative incidence of liver cirrhosis was 4.5%, 5.9%, 9.8%, 23.5% and 36.2% for patients with baseline serum HBV DNA serum levels of 300, 300–9.9 x 103, 104–9.9 x 104, 105–9.9 x 105 and ≥106 copies/mL, respectively. The greatest cumulative incidence of cirrhosis (36.2%) was observed in patients with serum HBV DNA levels of ≥106?copies/mL. However, it is interesting to note that the 1,563 patients (44%) with HBV DNA levels of 104?copies/mL or more accounted for 274 (75%) of the cirrhosis cases. * Cumulative Incidence of Hepatocellular Carcinoma by Serum HBV DNA Level at Study Entry (Entire Cohort, n=3653) * * This slide shows Histological improvement with durable HBV DNA suppression in the Global long-term entecavir study. After long-term treatment with Entecavir, 96% (55/57) of patients demonstrated histologic improvement which was increased from 73% (46/52) with histologic improvement at after 48 weeks of therapy. The proportion of patients demonstrating improvements in Ishak Fibrosis score also increased, from 32% (19/62) after 48 weeks to 88% (50/57). 100% patients achieved HBV DNA 300 copies/mL at the time of long-term biopsy, indicating the importance of durable HBV DNA suppression in improving