摘要
慢性丙型肝炎(CHC)病毒感染和相关肝病仍然具有挑战性,世界各地的疾病负担仍然很大。慢性感染患者的总体治疗率“非常差”,在现实的临床环境中,聚乙二醇化干扰素(PEG-IFN)和利巴韦林(RBV)双重治疗的完成情况并不理想。第一代、第二代和下一代直接作用抗病毒药物(DAAS)的批准是丙型肝炎病毒(HCV)治疗方法在治疗CHC感染者方面的重大突破。这种固定剂量组合(FDC)或RBV的治疗方案已经证明了它们对不同HCV基因型的临床疗效,并且难以治疗特殊人群。我们继续看到新的泛基因型抗-HCV方案的发展,其持续病毒学应答(SVR;第12周或治疗结束时检测不到的病毒载量)非常高,对药物抵抗的高屏障,不良事件的发生率较低,与一些老的基于RBV的三重DAA疗法相比,药物相互作用更少。口服无干扰素DAAS似乎是治疗丙型肝炎的非常成功的战略治疗方法,并促使卫生政策制定者制定治疗优先顺序和政策,以降低丙型肝炎相关发病率和死亡率。本文全面综述了无干扰素抗-HCV方案,这些方案在一定程度上改变了丙型肝炎的治疗模式,并带来了一些额外的好处,以激励我们在不久的将来努力实现消除HCV的全球目标。
关键词: 无干扰素抗病毒药物、蛋白酶抑制剂、NS5a抑制剂、NS5b抑制剂、泛基因型治疗方案、DAA失败、HCV治疗。
Current Molecular Medicine
Title:All Oral Interferon-free Direct-acting Antivirals as Combination Therapies to Cure Hepatitis C
Volume: 18 Issue: 7
关键词: 无干扰素抗病毒药物、蛋白酶抑制剂、NS5a抑制剂、NS5b抑制剂、泛基因型治疗方案、DAA失败、HCV治疗。
摘要: Chronic hepatitis C (CHC) virus infection and associated hepatic diseases are still challenging, and the disease burden remains significant around the world. Overall treatment rates for the chronically infected patients have been “dismally poor” and that treatment completion of dual-therapy— pegylated interferon (PEG-IFN) and ribavirin (RBV) is suboptimal in the real-world clinical settings. The approval of first, second and next-generation direct-acting antivirals (DAAs) represents a major breakthrough in hepatitis C virus (HCV) therapeutics to treat CHC infected individuals. Such therapeutic regimens in a fixed dose combination (FDC) or along with RBV have proven their clinical efficacy against different HCV genotypes, and harder-to-treat special populations. We continue to see the development of novel pan-genotypic anti-HCV regimens with very high sustained virologic response (SVR; undetectable viral load at week 12 or at the end of therapy) rates, high barrier to drug resistance, low frequency of adverse events, and fewer drug-drug interactions as compared to some older RBV based triple DAA therapies. Oral interferon-free DAAs seem highly successful strategic treatment approaches against hepatitis C and impulse health policy makers to establish the treatment priorties and policies to reduce the rate of hepatitis C-related morbidity and mortality. This review article comprehensively overviews interferon-free anti-HCV regimens, which have totally shifted the treatment paradigms for hepatitis C with some additional benefits to galvanize our efforts to achieve the global goal of HCV elimination in near future.
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Cite this article as:
All Oral Interferon-free Direct-acting Antivirals as Combination Therapies to Cure Hepatitis C, Current Molecular Medicine 2018; 18 (7) . https://dx.doi.org/10.2174/1566524019666190104110439
DOI https://dx.doi.org/10.2174/1566524019666190104110439 |
Print ISSN 1566-5240 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5666 |
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