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Use of tenofovir, lamivudine, or emtricitabine without a fully suppressive HAART regimen should be prevented due to the rapid growth of drug-resistant HIV mutations. In coinfected patients who require therapy for chronic hepatitis B, HIV, or both, many specialists would initiate a completely suppressive regimen to treat HIV infection that includes a twin nucleoside analogue spine with drugs lively in opposition to each HIV and HBV plus a third agent lively against HIV; this approach may reduce the chance for IRIS, significantly in patients with advanced immune deficiency. Seven medications have been authorized to treat chronic hepatitis B infection in adults: interferons (both normal and pegylated); nucleoside analogues (i.e., lamivudine; telbivudine; and entecavir); and the nucleotide analogues, adefovir and tenofovir. Preferred initial therapies for adults who have chronic hepatitis B without HIV infection embody pegylated interferon-alfa, entecavir, or adefovir monotherapy. 6 months); or 2) proof of chronic hepatitis on liver biopsy (BII) (641,657). Children with out necroinflammatory liver illness often don't warrant antiviral therapy (DIII). Necroinflammatory liver disease then can happen, during which serum transaminase ranges improve, along with excessive HBV DNA ranges and HBeAg positivity. The goals of therapy for youngsters with chronic hepatitis B infection are similar to these for adults: suppression of HBV replication; normalization of serum transaminase levels; acceleration of HBeAg seroconversion; preservation of liver architecture; and prevention of lengthy-term sequelae, reminiscent of cirrhosis and HCC. |
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发表于 2024-10-1 16:03:43