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ҽʦI94-ҽѧרʻƽ-ֿ

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1. This document discusses the treatment and management of hepatitis B in Taiwan. It provides guidelines for the treatment of hepatitis B based on disease severity and stage. 2. The guidelines outline 9 treatment criteria based on factors like HBeAg status, ALT levels, liver stiffness measurements, and genotype. First-line treatments recommended are pegylated interferon-alfa or nucleoside analogues like entecavir and tenofovir. 3. The guidelines aim to help eradicate hepatitis B in Taiwan through effective disease management and treatment according to the criteria provided. Regular monitoring of disease markers and liver function is important to determine treatment response and progression.

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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) 10:1C98

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ҽʦI94-ҽѧרʻƽ-ֿ

  • 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) 10:1C98