醫學專欄~黃健明-B肝治療現況

1. B
B
21.8%
14.2%
B
1997
(Lamivudine) B
2015 B
( Entecavir,
Tenofovir )
(Pegylated-IFN- alfa) B
( )
HBsAg ( 3-5%)
(<1%)
HBeAg
HBeAg
HBeAg ALT
genotype A

2. ( )
B :
(Pegylated-IFN-
alfa)
(Entecavir
Tenofovir)
( <2000 IU/ml)
ALT
(undetectable)
ALT
48
B
: ( )
( ) ALT
( )
1.
2.
>2000 IU/ml .
3.
( prothrombin
time prolonged by more than 3seconds)
INR 1.5
4.
ALT > 2 X upper limt of normal
(ULN) ( )
HBeAg
>20,000 IU/ml HBeAg
>2000 IU/ml
5. (HBeAg
>20,000 IU/ml
HBeAg
>2000 IU/ml) ALT
< 2 X upper limt of normal (ULN)
Fibroscan
APRI
35
;

3. 6. HBeAg
< 20,000 IU/ml
35 ;
7. HBeAg
< 2000 IU/ml
35
;
8.
Fibroscan
Mean liver stiffness 8 kPa
APRI 1.5
9.
( Tenofovor or Enteca-
vir)
Tenofovir
Tenofovir
Entecavir
Entecavir
1.2%
Tenofovir Entecavir
(<
1%)
1%
Hypophosphatemia ( < 2g/ml )
Entecavir Class
C
Tenofovir
Class B
B

4. 1.Towards the eradication of hepatitis B in
Taiwan.
Suzanne Wait a, Ding-Shinn Chen b,
a SHW Health Ltd, London, United Kingdom
b Department of Internal Medicine, Hepatitis
Research Center and Graduate Institute of
Clinical Medicine,
National Taiwan University College of
Medicine and National Taiwan University
Hospital, Taipei, Taiwan
Kaohsiung Journal of Medical Sciences (2012)
28, 1-9.
2.$VLDQ3DFL¿F FOLQLFDO SUDFWLFH JXLGHOLQHV RQ WKH
management of hepatitis B: a 2015 update.
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6 6 =KHQJ‡ - + .DR
Hepatol Int (2016) 10:1–98