核苷(酸)类似物治疗慢性乙型肝炎的停药 策略：现状与展望
Withdrawal Strategies of Nucleos (t) Ide Analogues in the Treatment of Chronic Hepatitis B: Current Status and Prospects
摘要: 慢性乙型病毒性肝炎(CHB)是由乙型肝炎病毒(HBV)持续感染引起的全球严重公共卫生问题，影响着全球约2.96亿人，每年导致约110万人死于肝硬化、肝衰竭和肝细胞癌(HCC)等相关并发症。核苷(酸)类似物(NAs)作为当前CHB抗病毒治疗的主要药物之一，通过强效抑制病毒复制显著改善了患者预后，但长期治疗带来的经济负担、潜在副作用和患者依从性等问题使得停药策略成为临床关注焦点。本文系统综述了NAs治疗CHB的停药标准、预测指标、东西方人群差异、停药后管理及未来研究方向，旨在为临床医师制定个体化治疗方案提供循证医学依据，并探讨通过有限疗程实现功能性治愈的可能性。
Abstract: Chronic viral hepatitis B (CHB) is a serious global public health problem caused by persistent hepatitis B virus (HBV) infection, affecting about 296 million people worldwide and leading to about 1.1 million deaths each year from cirrhosis, liver failure and hepatocellular carcinoma (HCC) and other related complications. Nucleos (t) ide analogues (NAs), as one of the main drugs for CHB antiviral therapy, have significantly improved the prognosis of patients by strongly inhibiting viral replication. However, the economic burden, potential side effects, and patient compliance caused by long-term treatment have made the withdrawal strategy become a clinical focus. This article systematically reviews the withdrawal criteria, predictors, differences between eastern and western populations, post-withdrawal management, and future research directions of NAs for CHB treatment, aiming to provide evidence-based medical basis for clinicians to formulate individualized treatment plans and explore the possibility of achieving functional cure through limited treatment courses.
文章引用：晏军莲, 任红. 核苷(酸)类似物治疗慢性乙型肝炎的停药 策略：现状与展望[J]. 临床医学进展, 2026, 16(4): 5058-5068. https://doi.org/10.12677/acm.2026.1641779

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