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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
( )
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
;
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
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.
6 . 6DULQ‡ 0 .XPDU‡ * . /DX‡ = $EEDV‡
+ /  KDQ‡  - KHQ‡
' 6 KHQ‡ + / KHQ‡ 3 - KHQ‡ 5 1
KLHQ‡$ . 'RNPHFL‡ (G *DQH‡
- / +RX‡ : -DIUL‡ - -LD‡ - + .LP‡ /
/DL‡ +  /HH‡ 6 * /LP‡
 - /LX‡ 6 /RFDUQLQL‡0 $O 0DKWDE‡
50RKDPHG‡ 0 2PDWD‡ - 3DUN‡
7 3LUDWYLVXWK‡%  6KDUPD‡ - 6ROODQR‡ ) 6
:DQJ‡ / :HL‡ 0 ) XHQ‡
6 6 =KHQJ‡ - + .DR
Hepatol Int (2016) 10:1–98

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高雄醫師會誌94期-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. 6 . 6DULQ‡ 0 .XPDU‡ * . /DX‡ = $EEDV‡ + / KDQ‡ - KHQ‡ ' 6 KHQ‡ + / KHQ‡ 3 - KHQ‡ 5 1 KLHQ‡$ . 'RNPHFL‡ (G *DQH‡ - / +RX‡ : -DIUL‡ - -LD‡ - + .LP‡ / /DL‡ + /HH‡ 6 * /LP‡ - /LX‡ 6 /RFDUQLQL‡0 $O 0DKWDE‡ 50RKDPHG‡ 0 2PDWD‡ - 3DUN‡ 7 3LUDWYLVXWK‡% 6KDUPD‡ - 6ROODQR‡ ) 6 :DQJ‡ / :HL‡ 0 ) XHQ‡ 6 6 =KHQJ‡ - + .DR Hepatol Int (2016) 10:1–98