B肝病毒量低別放鬆 表面抗原也重要

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http://udn.com/NEWS/HEALTH/HEA1/7579480.shtml

【聯合晚報╱記者黃玉芳/台北報導】
2012.12.20 03:15 pm

B肝帶原者若檢測發現體內病毒量低，往往會鬆了一口氣，不過國內一份研究對2688名患者追蹤近15年，結果發現，即使病毒量低、但B型肝炎表面抗原濃度高者，罹患肝癌的機率會高出13.7倍。學者建議民眾做B肝檢測時，要做「病毒量」及「表面抗原」的雙指標，台大等各大醫院都可以檢測。
台灣B型肝炎醫療策進會理事長、台大醫學院臨床醫學研究所長高嘉宏，和國內研究肝炎權威陳定信、陳培哲等9位醫師，歷時約15年，追蹤2688位表面抗原陽性的B肝患者，發現表面抗原濃度高低，跟罹患肝癌的風險大小有關聯性。

高嘉宏說，目前B肝帶原者，普遍以B肝病毒數量作為判斷依據，國內曾有研究證實，病毒量大於2000(IU)者，未來罹患肝癌機率高，以致許多檢測發現病毒量小於2000(IU)的帶原者會鬆懈。

但根據追蹤發現，2688名患者中，仍有191人罹患肝癌，肝癌發生率為0.5%。研究證實，即使病毒數量低，但如果表面抗原濃度高，比起表面抗原濃度低者，罹患肝癌的機率竟然高出13.7倍。

高嘉宏說，表面抗原只要抽血檢驗就能得知，因此未來希望能推動B肝檢測的雙指標，醫療院所不僅要驗帶原者的病毒量、也要驗表面抗原的濃度高低。

對於病毒量低、表面抗原低，罹患肝癌的機率屬於「微小風險」，高嘉宏建議，僅要一年追蹤一次，但如果病毒量低、表面抗原高，則建議三個月到半年追蹤一次，一發現肝功能異常，要積極治療。

表面抗原除了可以作為預測肝癌的風險因子，高嘉宏說，也可以作為治療的判定依據，對於目前以注射干擾素治療B肝患者，可以於用藥第12周時檢驗，若發現表面抗原濃度仍居高不下，就可以預測未來的治療效果不佳，及早調整治療方式。

[LCL]

注射干擾素治療B肝患者?
現在不是大都用吃的

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