【摘要】 肝硬化患者抗病毒治疗的必要性和可行性备受关注。综述近年相关指南/共识和循证医学资料,介绍HBV和HCV相关肝硬化抗病毒治疗的适应证、治疗策略、药物选择及治疗收益/风险等方面的进展。资料显示,无论乙型肝炎还是丙型肝炎肝硬化,成功的治疗均可抑制病毒复制,改善病情,延缓疾病进展,延长生存期,减少并发症发生,并为相关肝细胞癌的外科和微创手术创造条件。因核苷和核苷酸类药物安全性好,推荐乙型肝炎肝硬化(包括失代偿期甚至出现并发症)患者尽早使用;而干扰素不良反应多,丙型肝炎肝硬化抗病毒较乙型肝炎困难,须慎重选择适应证。规范抗病毒方案对治疗肝硬化非常重要。更多还原

【Abstract】 The necessity and feasibility of antiviral therapy in patients with liver cirrhosis have caught much attention. By summarizing the relevant guidelines /consensus statements and evidence- based medicine data in recent years,the advances in indications,strategies,drug options,and benefit /risk in antiviral therapy for hepatitis B virus(HBV)- and hepatitis C virus(HCV)- related cirrhosis are reviewed. The data reveal that for both HBV- and HCV- related cirrhosis,successful treatment may suppress viral replication,improve patients’ conditions,delay disease progression,prolong survival,reduce complications,and create better conditions for surgical and minimally invasive operations for hepatocellular carcinoma. Because of the good safety of nucleos(t)ide analogues(NA),it is recommended that patients with HBV- related cirrhosis(including those in decompensation stage and with complications) should receive NA as soon as possible. As interferon may cause many adverse reactions,antiviral therapy for HCV- related cirrhosis becomes more difficult than that for HBV- related cirrhosis. Careful selection of indications is necessary. Standardization of the strategies for antiviral therapy is important in the treatment of liver cirrhosis.更多还原