全球,约有2.4亿人患有慢性乙型肝炎病毒(HBV),非洲和亚洲感染率最高。我们对HBV感染的自然史和由此产生的疾病的治疗潜力的理解正在不断提高。新的数据已经成为自2012年出版的HBV感染的管理APASL指南。本手稿的目的是更新慢性HBV感染的最佳管理建议。2015年指南是由APASL选出的亚洲专家小组制定的。临床实践指南基于现有出版物的证据,或者,如果没有证据,专家们的个人经历和审议后的意见。截至2015年1月出版的重要会议的手稿和摘要已经过评估。本指南涵盖了感染乙型肝炎的患者的全方位护理,包括新的术语,自然史,筛选,疫苗接种,咨询,诊断,评估肝脏疾病的阶段,适应症,定时,单一或联合抗病毒药物的选择和持续时间,肝癌筛查,像童年这样特殊情况下的管理,怀孕,合并感染,肾功能损害和肝移植前后,和政策方针。然而,不确定的领域仍然存在,和临床医生,病人,因此,公共卫生当局必须继续根据不断发展的证据做出选择。最后的临床实践指南和建议在这里提出,以及相关的背景资料。
Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL
guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015
guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice
guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts\' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This
guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice
guidelines and recommendations are presented here, along with the relevant background information.