2008NAGH 荷兰国家慢性乙肝病毒感染防治指南
The development of this guideline was initiated and coordinated by the Netherlands Association of Gastroenterologists and Hepatologists.The aim is the establishment of national standards in the evaluation and antiviral treatment of patients with chronic hepatitis b virus (HbV)infection. This includes recommendations on the initial evaluation of patients, choice and duration of antiviral therapy, follow-up after antiviral therapy and monitoring of patients not currently requiring antiviral therapy.The initial evaluation of chronic H bV-infected patients should include testing of liver biochemistry, virus serology and abdominal imaging. In patients without cirrhosis, antiviral treatment is recommended for those with a serum HbV dNA of at least 1.0 x 105c/ml (≥2.0 x 104iU/ml) in combination with:a) elevation of serum alanine aminotransferase (AlAT) level above twice the upper limit of normal during at least three months, and/or b) histological evidence of porto-portal septa or interface hepatitis on liver histology. in patients with cirrhosis, antiviral treatment is recommended if serum HbV dNA is 1.0x104c/ml (≥2.0 x 103iU/ml)or higher, independent of Al AT levels or histological findings. if the patient has decompensated cirrhosis, antiviraltreatment is recommended if serum H bV dNA is 1000 c/ml (≥200 iU/ml) or higher.
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