乙型肝炎的治療

慢性乙型肝炎是否有根治方法？

對于慢性携帶者來說，好消息是有若干種很有希望的治療方法。而十年以前病人沒有這種選擇。現在有藥物能够减緩病毒對肝臟的侵害，這意味著您今後患上嚴重肝病的機率也較低。有時這些藥物甚至能够清除病毒，儘管這幷不常見。有了所有這些令人振奮的新研究，爲慢性携帶者尋求根治方法的希望就更大。

什麽是慢性乙型肝炎已經獲得獲准的藥物？

對患有慢性乙型肝炎的病人來說，美國有幾種經過批准的藥物。這幾種藥也在中國提供:

Epivir-HBV 或 Zeffix (lamivudine) 是一種口服藥片，一天服用一次，幾乎沒有副作用,服用至少一年或一年以上。主要問題是治療時和治療後可能會發生乙型肝炎病毒變异。于1998 年批准，可用于兒童和成人。

Hepsera (adefovir dipivoxil)s 是一種口服藥片，一天服用一次，副作用很少，服用至少一年或一年以上。主要問題是服用此藥可能會發生腎臟問題。于2002 年9月批准，僅可用于成人。兒科臨床試驗正在進行中。

Baraclude (entecavir：恩替卡韋)是一種每日服用的片劑，可連續服用長達一年而幾乎沒有任何副作用。這種藥在目前用來治療慢性乙型肝炎的口服抗病毒藥物中，被普遍認爲是藥效最强的一種。此藥于2005年4月獲得批准，幷僅供成人使用。今後可能要進行兒科臨床試驗。

Tyzeka (telbivudine) 是一種每日服用的片劑，可連續服用一年而幾乎沒有任何副作用。研究顯示該藥能迅速有效地抑制乙肝病毒。于2006年10月批准用于成人。

Intron A (alpha干擾素) 是一種注射藥物， 一周注射數次，用六個月到一年，有時或更久，此藥可能會引起象感冒﹑憂鬱症和頭痛一樣症狀的副作用，于1991年批准，可用于兒童和成人。

Pegasys (pegylated interferon：聚乙二醇化干擾素) 是一種注射藥物，每周注射一次，通常要連續注射六個月到半年。這種藥可能會有副作用，如流感症狀、抑鬱症和其它心理健康問題。此藥于2005年5月獲得批准，幷僅供成人使用。

不是每一個慢性型肝炎患者都需要用藥﹐瞭解這一點很重要。一些患者只需要由其醫生定期監測 (至少一年一次)。有肝病活動症狀的患者最有可能從治療中獲益。請務必和您的醫生談一談您是否可以從治療中獲益幷討論一下治療方案。此外﹐在臨床實驗和研究渠道中都有令人鼓舞的新藥。

所有慢性乙型肝炎患者不論是否接受治療都要定期看醫生﹐這是至關重要的﹗﹗

是否有任何新藥物正在研製之中？

目前有若干種很有希望的新型乙型肝炎治療藥物正在試驗中。 某些正在實驗室中試驗。其它藥物則在患者中測試—此類測試稱爲“臨床試驗。”醫生們小心地選擇試用藥物的病人。目標是確保藥物的安全性和正常功能。任何藥物在獲准投入全面使用之前，均必須予以臨床試驗。這一測試程序可能需要很長時間。

乙型肝炎基金會的藥物監測

乙型肝炎基金會保持一份慢性乙型肝炎已獲准藥物和潜在的新藥物清單。我們追踪處于研究階段及臨床試驗中的藥物。請查閱我們的《藥物監測圖》。該圖以英文編寫，這僅僅是因爲信息更改極爲頻繁。謝謝您的耐心和理解。

Hepatitis B Treatment

Is there a cure for chronic hepatitis B?
The good news is that there are promising new treatment for people living with chronic hepatitis B. Today, there are several approved drugs in the United States that can slow down liver damage caused by the virus.

The new drugs can help slow the progression of liver disease in chronically infected people by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus. With all of the new exciting research, there is great hope that a complete cure will be found for chronic hepatitis B in the near future.

What are the approved drugs for chronic hepatitis B?
Currently, there are several approved drugs in the United States for people who have chronic hepatitis B infections:

Approved Hepatitis B Drugs in the United States

• Interferon-alpha (Intron A) is given by injection several times a week for six months to a year, or sometimes longer. The drug can cause side effects such as flu-like symptoms, depression, and headaches. Approved in 1991 and available for both children and adults.
  
• Pegylated interferon (Pegasys) is given by injection once a week usually for six months to a year. The drug can cause side effects such as flu-like symptoms, depression and other mental health problems. Approved May 2005 and available only for adults.
  
• Lamivudine Epivir-HBV, Zeffix, or Heptodin) is a pill that is taken once a day, with almost no side effects, for at least one year or longer. A primary concern is the possible development of hepatitis B virus mutants during and after treatment. Approved in 1998 and available for both children and adults.
  
• Adefovir dipivoxil (Hepsera) is a pill taken once a day, with few side effects, for at least one year or longer. The primary concern is that kidney problems can occur while taking the drug. Approved September 2002 and available only for adults. Pediatric clinical trials are being planned.
  
• Entecavir (Baraclude) is a pill taken once a day, with almost no side effects for up to one year. It is considered to be the most potent oral antiviral drug for chronic hepatitis B to date. Approved April 2005 and available only for adults. Pediatric clinical trials may be planned for the future.
  
• Telbivudine (Tyzeka) is a pill taken once a day, with almost no side effects. Approved October 2006 and available only for adults. Pediatric clinical trials may be planned for the future.

It is important to know, not every chronic hepatitis B patient needs to be on medication. Some patients only need to be monitored by their doctor on a regular basis (at least once a year, or more). Other patients with active signs of liver disease may benefit the most from treatment. Be sure to talk to your doctor about whether you could benefit from treatment and discuss the treatment options. In addition, there are promising new drugs in clinical trials and in the research pipeline.

However, it is vital that all people with chronic hepatitis B visit their doctor on a regular basis, whether they receive treatment or not!

Are there any new drugs in the research pipeline?
There are several promising new drugs for hepatitis B in the experimental stage. Some are still being tested in the laboratory. Other drugs are being tested in small groups of people -- these tests are called "clinical trials". Doctors carefully select their patients to test new drugs. They keep close track of these patients while they are taking the drug. The goal is to make sure the drug is safe and that it works. Clinical trials must be done before any new drug can be approved for general use and this can take many years.

Hepatitis B Foundation's Drug Watch
The Hepatitis B Foundation maintains a list of both approved drugs and promising new treatments for chronic hepatitis B. We keep track of drugs that are in the research phase and also in clinical trials. Please check our Drug Watch Chart. This chart is written in English only because the information changes so frequently. Thank you for your patience and understanding.