Nucleoside (acid) is a kind of hepatitis B antiviral drugs, effective, easy to use, widely used in clinical treatment. However, there is als
Nucleoside (acid) is a kind of hepatitis B antiviral drugs, effective, easy to use, widely used in clinical treatment. However, there is also a need for attention in the treatment of nucleoside (acid) drugs
First, in terms of efficacy. Most of the patients receiving nucleoside (acid) drugs after the illness may be improved, but also may be ineffective, including no response or partial response or virological breakthrough of treatment, then you need to adjust the treatment plan. The second is the long-term treatment problems, although the guidelines for the prevention and treatment of chronic hepatitis B at home and abroad to nucleoside (acid), the provisions of the proposed treatment end point withdrawal standard analogues in treatment of chronic hepatitis B, but the evidence for these standards is not sufficient. Clinical practice shows that, even in accordance with the current domestic and international standards for chronic hepatitis B management guidelines or consensus recommendations, the recurrence rate is still high. It is generally believed that nucleoside (acid) drugs need long-term medication can be long-term stability. However, the risk of long-term drug resistance is also increasing, such as lamivudine resistance mutation rate of 4 years has reached 66%. If the patient is young or middle-aged, especially childless men and women, is not easy to accept long-term medication, then the short term can stop the interferon will be a better choice. In addition, the side effects of drugs can not be ignored. Nucleoside (acid) drugs overall safety is good, but in the long process of medicine safety problem is still underestimated. For example, tenofovir is a nucleoside (acid) is one of the preferred class of antiviral drugs, but the renal toxicity, monitoring of renal function during treatment. Other such as telbivudine and adefovir dipivoxil has potential neuromuscular toxicity or renal toxicity and other issues, the use must be monitored
How to avoid these problems? The best way is to do a regular review, timely detection, early treatment
The review includes: liver function, namely glutamic acid aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, albumin, etc.. After the start of treatment 1 times a month, for a total of 3 times, with the improvement of the disease can be made every 3 months for 1 times; second, virological markers, including hepatitis B, hepatitis B virus DNA two. In general, after the start of treatment for 1 to 3 months to detect 1 HBVDNA quantitative and two semi hepatitis B, after every 3 to 6 months 1 times; the AFP (3 ~ 6 months 1 times) and abdominal ultrasonography, CT (6 to 12 months, 1 times) to monitor the condition changes, convenient screening and detection of liver cancer; the other projects, such as drug selection including blood, serum creatinine and creatine kinase, check to monitoring of adverse drug reactions.
In conclusion, hepatitis B patients receiving nucleoside (acid) treatment is not equal to the periodic review, pay attention to sleep without any anxiety, understand the changes of disease, drug efficacy and safety problems, in order to avoid trouble.
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