高正常ALT慢性乙型肝炎患者应否启动抗病毒治疗

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高正常ALT慢性乙型肝炎患者应否启动抗病毒治疗

李欣洁; 沈弢; 庄辉

临床肝胆病杂志, 08/2023, Volume: 39, Issue: 8

Journal Article

现行指南建议对ALT升高和HBV DNA 阳性慢性乙型肝炎(CHB)患者给予抗病毒治疗.但越来越多的研究表明,血清高正常ALT(0.5～1 倍正常值上限)慢性HBV感染者的肝组织可见显著坏死炎症和/或纤维化,并存在进展性肝病如肝硬化、肝细胞癌、乙型肝炎相关并发症甚至死亡的风险.本文讨论了血清高正常ALT的定义、血清高正常ALT慢性乙型肝炎患者的临床和病毒学特点,以及对此类患者应否启动抗病毒治疗.

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李欣洁 | 沈弢 | 庄辉

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