慢性乙肝很難治愈,隻能控製。網站不同說法大致相同。對於治愈,不同學術網站也有不同的說法,取決於它們各自的定義。
1.Cleavland clinic:
"How do you get chronic hepatitis B?
Chronic hepatitis B develops when your immune system fails to fight off the virus. Most people successfully fight it off during the acute phase of the infection. The acute phase is when your immune system recognizes the virus and launches its attack."
https://my.clevelandclinic.org/health/diseases/4246-hepatitis-b
2. 維基百科
"嬰兒經由母親垂直感染B型肝炎後,有90%的機率成為慢性B型肝炎帶原者;而5歲後才感染B型肝炎者,長大後隻有不到10%會成為慢性帶原者[4]。雖然大部分慢性肝炎患者沒有症狀,但卻有機會發展為肝硬化甚至肝癌[2],亦為慢性肝炎患者死因的15%至25%[1]。"
3. 對於治愈也有不同的定義:1)根除行治愈(沒有乙肝DNA), 2)臨床治愈,沒有症狀,血清HbsAg 長期陰性。
4. 這是一份44個乙肝住院病人的5年追蹤報告,41個病人清除了表麵抗原 ,3/44(6.8%)轉為慢性感染
Long-Term Follow-Up of Acute Hepatitis B: New Insights in Its Natural History and Implications for
Antiviral Treatment
3.2. Clinical Outcome, Natural History and HBsAg Clearance
All 75 patients were cared for as inpatients for a few days on supportive treatment: Hydration, glucose, and electrolytic balance. Three patients with particularly high levels of liver damage were treated with entecavir until anti-HBsAg seroconversion. After clinical improvement, all patients were discharged, and most were further followed at the same center as outpatients. Clinical data recorded during the hospital stay or collected during follow-up visits were analyzed for the study. None of the patients reported or were documented as having been vaccinated. Twenty-six patients were lost during follow-up after a short hospital stay, 49 were followed as outpatients for a variable amount of time. Of these, 44 were followed to HBsAg clearance or for longer than five years. For the purposes of this study, HBsAg clearance was defined as the intermediate time between the last positive and the first negative result. By this definition, 36/44 patients cleared HBsAg within six months (Rapid Resolvers, RR), as shown in Figure 2A. Of the other eight (Slow Resolvers, SR), three (3/44, 6.8%) developed a true chronic HBeAg+ infection (>4 years now, two of them requiring chronic antiviral treatment). SR were infected with: Four genotype A, two genotype F, and one of genotype D and B respectively. Of these, two genotype A and one genotype B infections became chronic. Genotype D infection in adults showed the lowest probability of lasting longer than six months (6.7% vs. 22% non–D genotypes, not significant).