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摘要：
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摘要：慢性乙型肝炎病毒（hepatitis B virus，HBV）感染严重威胁人类健康。探讨慢性乙型肝炎
（chronic hepatitis B，CHB）抗病毒治疗方案可使更多患者临床获益。核苷（酸）类似物[nucleos(t)ide
analogues，NAs]及干扰素类（interferon，IFN）为目前主要的抗病毒药物，CHB患者经规范治疗可
有效抑制病毒复制、控制疾病进展。但这两类药物均无法直接作用于肝细胞内的cccDNA，CHB难
以实现彻底治愈。目前部分合适的CHB患者可追求临床治愈（持续病毒学应答且HBsAg阴转或伴有
抗-HBs阳转、ALT正常、肝组织病变轻微或无病变）。无论是IFN还是NAs，单一用药方案很难达到
临床治愈，新型抗HBV物开多处于临床前期，目前现有抗病毒治疗方案的优化是临床研究关注的问
题。NAs经治患者联合或序贯IFN治疗可提高病毒学应答率及HBeAg血清学转换率，使更多患者实现
临床治愈。影响HBsAg清除的因素较多，筛选有利于获得临床治愈患者的特征及制定个体化治疗方案
仍需深入研究。
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Abstract: Chronic hepatitis B virus (HBV) is a serious threat to human health. It is still necessary to explore
the antiviral treatment for chronic hepatitis B (CHB) to benefit more patients. Nucleos(t)ide analogue
(NAs) and interferon (IFN) are the main antiviral drugs. Standardized treatment for patients with CHB can
effectively inhibit viral replication and control the progress of the disease. However, these two drugs cannot
directly affect cccDNA in liver cells, and it is difficult to cure CHB completely. Some suitable patients with
CHB can pursue clinical cure (continuous virological response and HBsAg eliminated or accompanied by
anti-HBs positive, normal ALT, slight or no inflammation of liver tissue). Whether IFN or NAs, single drug
therapy is difficult to achieve clinical cure. Most new anti-hepatitis B virus drugs are in the pre-clinical stage,
which is not available. Currently, the optimization of the existing antiviral treatment scheme is a concern of
various clinical studies. In the current treatment strategies, NAs treated patients with sequential or combining
IFN may improve the virological response rates and HBeAg serological conversion rate, which can make
more patients achieve clinical cure. It has been found that there are many factors influencing HBsAg
clearance. It is necessary to furtherly study the characteristics of patients who are promising to clinical cure
and to formulate individualized treatment plans.
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