Chronic second liver runs a guide

Medicine of China of secretary-general of ill conference of liver of harbor Shanghai international Professor Liao Jiajie can affect south of committee member of ill chapter vice director, Guangzhou the healthy problem whole world that Hou Jinlin of director of hospital liver ill center teachs chronic second liver is global attention once had 2 billion, the person that the virus of nearly 25% is carried dies finally at cancer of the liver or liver cirrhosis. Professor Liao Jiajie weighs secretary-general of ill conference of liver of harbor Shanghai international: "The whole world has 75% to be in Asia-Pacific area in the person that liver virus carries 350 million chronic second, among them China is to get one of countries with the most serious effect, have the person that virus of liver of 93 million chronic second is carried about. " . The disease of liver of Asia-Pacific of new 2008 edition that releases in harbor learns chronic hepatitis B to run a guide (the following abbreviation " new guideline " ) emphasize strengthening cure to monitor, put forward clearly to stop medical principle: If patient of E antigen positive came true double amount to mark, namely virus does not detect with E antigen serological changeover, consolidate after treating a year, can stop drug. The top expert of country of 1.1 Asia-Pacific area establishs a reporter jointly on June 12 from " ill conference of liver of international of 2008 harbor Shanghai " on know: New guideline is considered to learn by Asia-Pacific liver (APASL) is rolled out, it is the core that by the tip that comes from country of 10 Asia-Pacific area clinical expert forms after program committee passes consistent consensus, make. Secretary-general of ill conference of liver of international of Shanghai of A-PASL**** , harbor Professor Liao Jiajie says, committee of program of liver of APASL chronic second is in a large number of new data were collected in 3 years in the past, decide to be made to APASL guideline update gravely, more clear guidance was provided on remedial program and program, promote antagonism second the capability of liver further. The commendation of new guideline the opinion includes the precaution of second liver, illness nature history, current cure choice, first-rate treats period of treatment, reach the proposal of clinical to future research. New guideline is being gone to already on the foundation of international consensus and guideline, brought into what appear recently to resist the new drug of second liver virus and plan, offerred the clinical and direct proposal with strong sex of simple palpability, operation. In the meantime, the choice using drug that new guideline pays close attention to the patient, directive opinion that stays the problem such as medicine to put forward to make clear. 2. Cure is crucial: The choice is individual the patient's condition that pair of patients want before the new guideline of the most comfortable plan that change emphasized deciding executive disease-resistant poison treats plan, phase, familial history, the element such as remedial history and economic condition undertakes be assessmented in the round mixing necessary communicate, in order to raise the comply with sex that the patient treats. Before, oversight of a lot of doctors evaluate with assessment value, forgot the long-term sex that poison of second liver disease-resistant treats, cannot choose proper remedy and method in right time consequently. To curative content recommend, new guideline include content of newest disease-resistant bane to replace decide than the husband, favour 4 kinds of nucleotide that replace Ka Wei inside (acerbity) kind medicaments labels a gleam of to use drug. Individual element of the patient and the main and clinical issue that need to solve are to decide to use why to plant the crucial essential factor of medicaments. For example, to accepting the gestation woman that profess to convinced medications, new guideline suggests to use the medicaments of gravid B class that makes clear at present to replace decide than the husband. In addition, if remedial target of the patient is,achieve terminus stopping drug as early as possible inside finite period, the principle stopping drug that should make clear by new guideline will choose appropriate remedy. 3. Stop medical principle clearly, enhance what patient confidence pays close attention to in the light of the patient to stop medical problem, new guideline advanced clear principle stopping drug. To the patient of E antigen positive, new guideline suggests, in interval in two examinations of at least 6 months, all show E antigen is serological changeover and virus detect electronegative, come true namely clinical those who go up is double amount to mark, consolidate after treating a year, with respect to terminable cure. To the patient of E antigen negative, be like successive 3, removed in the examination of at least 6 months, virus detects all indicate feminine gender, can consider to stop treatment. This kind of patient is average age is older, infection time is longer, remedial difficulty is greater. 4. Detect regularly, optimize proposal of remedial program new guideline, 3 months need the patient every other that accepts treatment undertake blood is checked, want especially advertent two main index, namely level of DNA of second liver virus and serum changeover. Serum changed antigen of the E in meaning blood to decrease, produce antibody at the same time, show resist the immunity that second liver virus affects is respondent strengthened. Serum changeover is a very main index, if the patient reachs this target, consolidate after treating a year, can consider to stop drug, and illness aggravation, suffer from on other liverish possibility is inferior also. Director of ill center of liver of southern hospital of committee member of vice director of chapter of catch a disease of move of China cure society, Guangzhou Professor Hou Jinlin emphasized detecting regularly the importance of level of DNA of second liver virus, especially the 24th week detect result. Professor Hou Jinlin says, "Remedial period the 24th week virus DNA level is very important, the basis is clinical go up the concept of applied route chart, doctor but according to the 24th week detect the curative effect that the result will come to forecast two years, judgement treatment is successful, if need, can adjust remedial strategy in time, avoid illness aggravation, decrease be able to bear or endure medical happening. In the meantime, also make the patient has an opportunity to stop drug, ease the worry of the economic burden that the patient brings to treating place for a long time. " the research that the professor still cited to be finished recently comes to 　 Hou Jinlin as a result prove DNA of the 24th week of virus detects the importance of the result, "The second liver patient of the E antigen positive that participates this research, taking for after deciding 24 weeks than the husband, if DNA of second liver virus does not detect, the opportunity that serum changeover realizes after two years is close 50% above, and more than most probably the patient still maintains in level of the virus after two years do not detect. " (the exercitation edits: Plum apricot)