慢性乙型肝炎患者管理（英文版）.ppt

Roadmap for Management of Patients with Chronic Hepatitis B (CHB)Prof. Xinxin ZhangRui Jin HospitalJiao Tong University Contents Introduction Presentation Objectives Data Review: Associations of HBV DNA with Outcomes i. Natural history studies ii. Impact of treatment Key role of HBV DNA in On-Treatment Management i. Timing and magnitude of HBV DNA suppression On-Treatment Roadmap Concept Summary and Conclusions IntroductionTreatment challenges highlight need for new management approach Treating hepatitis B virus (HBV) infection continues to be a challenge for physicians due to Complications arising from chronic HBV (CHB) The increasing number of available therapeutic options Treatment guidelines recognize the importance of monitoring and evaluation of treatment response; however, a standard on-treatment management approach does not exist To establish a new treatment paradigm, we should ask Does long-term suppression of HBV replication achieve the goals of treatment in CHB? Can the degree of on-treatment viral suppression predict outcomes? Does profound, early viral suppression at week 24 predict clinical outcomes? Can a Roadmap concept help achieve the goals of treatment in CHB? Presentation Objectives To explore the association between persistent viraemia and hepatitis disease progression To assess the relationship between the degree of viral suppression and clinical outcome To assess the role of early and effective viral load reduction and the association with clinical outcomes* To review an on-treatment management strategy – the roadmap concept – that may offer a valuable opportunity for enhanced treatment response Data Review: Associations of HBV DNA with Outcomes i. Natural history studies Cirrhosis: Association with Baseline HBV DNA Taiwan natural history study Hepatocellular Carcinoma (HCC)Association with baseline HBV DNA: Taiwan natural history study Data Review: Associations of HBV DNA with Outcomes ii. Impact of treatment Correlation Bet