Quantitative HBV DNA-Tracks-Antwort während der Nukleos(t)ide-analoge (NA) Therapie mit Ente...
Deterministische Ansicht der Quelle YAML Entität. Klinische Autorität bleibt mit den zitierten Quell-IDs und Rezensenten Sign-off Zustand.
| ID | BMA-HBV-DNA-MONITORING-ANTIVIRAL-RESPONSE |
|---|---|
| Art | Therapeutische Relevanz |
| Status | reviewed 2026-05-18 | actionability review required |
| Erkrankungen | DIS-HCC |
| Quellen | SRC-AASLD-HBV-2024 SRC-AASLD-HCC-2023 SRC-EASL-HBV-2025 |
Fakten zur Handlungsfähigkeit
| Biomarker | BIO-HBV-DNA-QUANTITATIVE-MONITORING |
|---|---|
| Variante | Quantitative HBV-DNA — virale Belastungsüberwachung während der Nukleos(t)id-Analogtherapie |
| Erkrankung | DIS-HCC |
| ESCAT-Stufe | IIIA |
| Empfohlene Kombinationen | Fortgesetzte antivirale Behandlung bei vollständiger Unterdrückung (Entecavir, TAF, TDF), HCC-Überwachung unabhängig von der DNA — siehe BMA-AFP-HCC-AASLD-SURVEILLANCE (US/AFP q6mo bei Zirrhosen und Hochrisiko-Nichtzirrhotika) |
| Kontraindizierte Monotherapie | lamivudine monotherapy (high resistance — superseded), adefovir monotherapy (low potency — superseded) |
| Zusammenfassung der Beweise | Quantitative HBV DNA tracks response during nucleos(t)ide-analogue (NA) therapy with entecavir (ETV) or tenofovir alafenamide/disoproxil (TAF/TDF). Effective suppression (HBV DNA <2,000 IU/mL, ideally undetectable) is the primary virologic response endpoint per AASLD HBV 2024 and EASL HBV 2025. Sustained suppression reduces HCC incidence by ~50-70% in CHB cirrhotics (REVEAL-HBV cohort; Wong 2013 meta-analysis). Primary non-response or viral breakthrough (≥1-log rise on therapy) prompts adherence review, resistance testing, and regimen change (rare with ETV/TAF/TDF — high genetic barrier). ESCAT IIIA — biomarker directs antiviral continuation/switch decisions and is the primary HCC-prevention lever in chronic HBV. |
Anmerkungen
STUB pending two-Co-Lead signoff. HCC anchor reflects the primary oncology endpoint of HBV antiviral therapy — long-term suppression reduces but does not eliminate HCC risk; surveillance continues regardless of virologic suppression in cirrhotics (AASLD HCC 2023). HBeAg seroconversion is a parallel response endpoint not captured in this BMA (covered separately under BIO-HBV-STATUS). Engine must not treat detectable but stable low-level viraemia (<2,000 IU/mL) as treatment failure — AASLD specifically permits this state on continued NA therapy.
Verwendet von
Keine Rückverweise im YAML-Korpus gefunden.