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专家提醒：乙肝抗病毒治疗不规范停药复发率超６０％
发布时间：2011-03-28      来源：
    经治复发已成为乙肝治疗关注的重点问题。有关专家日前提醒说，不规范停药复发率超60%。

　　北京佑安医院重症肝病科主任孟庆华26日在“慢乙肝经治复发患者治疗策略专家媒体见面会”上指出，年龄大、抗病毒巩固治疗时间短和ｅ抗原阴性是乙肝复发的三大预测因素。其中巩固治疗时间越久，患者复发率越低。一项关于经治患者用药时间与复发率的调研显示：巩固治疗时间少于1年，患者的复发率可达61.9%，而巩固治疗时间超过1年者，患者的复发率仅为8.7%。

　　关于规范停药，北京地坛医院副院长成军介绍说，大三阳患者，口服抗病毒药治疗后转为小三阳、乙肝病毒基因检测（ＨＢＶ　ＤＮＡ）转阴、转氨酶正常，在此基础上应再巩固治疗一年；而小三阳患者在治疗实现乙肝病毒基因检测转阴、转氨酶正常后应至少巩固治疗一年半，这样的情况下停药才是规范停药。也就是口服抗病毒治疗至少是2年至2年半。

　　但不容乐观的是，目前我国在慢乙肝口服抗病毒治疗领域，患者对规范治疗的依从性亟待提高，2009年一项针对患者依从性的万人调研结果发现：63%的慢乙肝患者在口服抗病毒药物过程中都曾经有过自行停药的行为。为此，专家提醒，乙肝患者抗病毒治疗时一定要规范治疗，不要擅自换药或停药。

　　中国工程院院士庄辉指出，慢乙肝经治复发患者与慢乙肝初治患者的情况完全不同，其中很多患者都曾用过至少一种口服抗病毒药物，经治复发患者病毒复杂度高，再治疗时耐药风险也会增加。但他同时表示，乙肝患者复发后仍然要坚定治疗信心，对抗乙肝病毒需要长期努力。

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