摘要
Hepatitis B virus (HBV) infection is a major public health problem, with an estimated 296 million people chronically infectedand 820 000 deaths worldwide in 2019. Diagnosis of HBV infection requires serological testing for HBsAg and for acute infectionadditional testing for IgM hepatitis B core antibody (IgM anti-HBc, for the window period when neither HBsAg nor anti-HBs isdetected). Assessment of HBV replication status to guide treatment decisions involves testing for HBV DNA, whereas assessmentof liver disease activity and staging is mainly based on aminotransferases, platelet count, and elastography. Universal infantimmunisation, including birth dose vaccination is the most effective means to prevent chronic HBV infection. Two vaccines withimproved immunogenicity have recently been approved for adults in the USA and EU, with availability expected to expand.Current therapies, pegylated interferon, and nucleos(t)ide analogues can prevent development of cirrhosis and hepatocellularcarcinoma, but do not eradicate the virus and rarely clear HBsAg. Treatment is recommended for patients with cirrhosis or withhigh HBV DNA levels and active or advanced liver disease. New antiviral and immunomodulatory therapies aiming to achievefunctional cure (ie, clearance of HBsAg) are in clinical development. Improved vaccination coverage, increased screening,diagnosis and linkage to care, development of curative therapies, and removal of stigma are important in achieving WHO's goalof eliminating HBV infection by 2030.
出处
《四川生理科学杂志》
2023年第2期271-271,共1页
Sichuan Journal of Physiological Sciences
