CAJ | 학술논문

肝硬化患者抗病毒治疗的必要性和可行性备受关注。综述近年相关指南／共识和循证医学资料，介绍HBV和HCV相关肝硬化抗病毒治疗的适应证、治疗策略、药物选择及治疗收益／风险等方面的进展。资料显示，无论乙型肝炎还是丙型肝炎肝硬化，成功的治疗均可抑制病毒复制，改善病情，延缓疾病进展，延长生存期，减少并发症发生，并为相关肝细胞癌的外科和微创手术创造条件。因核苷和核苷酸类药物安全性好，推荐乙型肝炎肝硬化（包括失代偿期甚至出现并发症）患者尽早使用；而干扰素不良反应多，丙型肝炎肝硬化抗病毒较乙型肝炎困难，须慎重选择适应证。规范抗病毒方案对治疗肝硬化非常重要。
간경화환자항병독치료적필요성화가행성비수관주。종술근년상관지남／공식화순증의학자료，개소HBV화HCV상관간경화항병독치료적괄응증、치료책략、약물선택급치료수익／풍험등방면적진전。자료현시，무론을형간염환시병형간염간경화，성공적치료균가억제병독복제，개선병정，연완질병진전，연장생존기，감소병발증발생，병위상관간세포암적외과화미창수술창조조건。인핵감화핵감산류약물안전성호，추천을형간염간경화（포괄실대상기심지출현병발증）환자진조사용；이간우소불량반응다，병형간염간경화항병독교을형간염곤난，수신중선택괄응증。규범항병독방안대치료간경화비상중요。
The necessity and feasibility of antiviral therapy in patients with liver cirrhosis have caught much attention.By summarizing the rel-evant guidelines/consensus statements and evidence-based medicine data in recent years,the advances in indications,strategies,drug op-tions,and benefit/risk in antiviral therapy for hepatitis B virus (HBV)-and hepatitis C virus (HCV)-related cirrhosis are reviewed.The data reveal that for both HBV-and HCV-related cirrhosis,successful treatment may suppress viral replication,improve patients′conditions, delay disease progression,prolong survival,reduce complications,and create better conditions for surgical and minimally invasive operations for hepatocellular carcinoma.Because of the good safety of nucleos(t)ide analogues (NA),it is recommended that patients with HBV-related cirrhosis (including those in decompensation stage and with complications)should receive NA as soon as possible.As interferon may cause many adverse reactions,antiviral therapy for HCV-related cirrhosis becomes more difficult than that for HBV-related cirrhosis.Careful se-lection of indications is necessary.Standardization of the strategies for antiviral therapy is important in the treatment of liver cirrhosis.