慢乙肝抗病毒治疗现状及实现慢乙肝临床治愈的治疗策略
Current Status of Antiviral Therapy for Chronic Hepatitis B and Therapeutic Strategies for Achieving Clinical Cure of Chronic Hepatitis B
摘要: 慢性乙型肝炎(Chronic Hepatitis B，CHB，慢乙肝)是全球性的健康问题。抗病毒治疗是目前主要的治疗手段，能明显改善肝脏的炎症和纤维化情况，进而缓解、阻止甚至逆转疾病向肝硬化、肝衰竭或肝癌的进展。目前，抗病毒治疗主要分为两大类：口服抗病毒药物、干扰素。尽管口服抗病毒药物能有效抑制乙型肝炎病毒DNA (Hepatitis B Virus DNA, HBV DNA)，但难以清除乙型肝炎表面抗原(HBsAg)实现临床治愈。长效干扰素作为免疫调节剂，具有打破免疫耐受、促进HBsAg清除的潜力，但应用受到了一定的限制。实现CHB临床治愈仍面临诸多挑战。本综述旨在阐述当前CHB抗病毒治疗的现状，重点讨论了实现临床治愈的多种治疗策略，并对未来的研究方向进行展望，以期提高CHB的临床治愈率。
Abstract: Chronic hepatitis B (CHB) represents a significant global health challenge. Antiviral therapy remains the primary treatment modality, effectively reducing liver inflammation and fibrosis, and consequently slowing, halting, or even reversing disease progression to liver cirrhosis, liver failure, or hepatocellular carcinoma. Currently, antiviral therapies are primarily categorized into two groups: oral nucleoside analogs and interferon-based treatments. While oral nucleoside analogs efficiently suppress hepatitis B virus DNA (HBV DNA), they struggle to clear hepatitis B surface antigen (HBsAg), which is essential for achieving a clinical cure. Long-acting interferon, acting as an immunomodulator, holds promise in breaking immune tolerance and promoting HBsAg clearance; however, its use is limited. Achieving a clinical cure for CHB remains fraught with challenges. This review summarizes the current landscape of antiviral therapy for CHB, critically evaluates various strategies aimed at achieving clinical cure, and explores potential future research directions to enhance the clinical cure rate of CHB.
文章引用：赖婷婷, 黄英. 慢乙肝抗病毒治疗现状及实现慢乙肝临床治愈的治疗策略[J]. 临床医学进展, 2025, 15(6): 297-305. https://doi.org/10.12677/acm.2025.1561727

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