Combination therapy in the treatment of chronic viral hepatitis and prevention of hepatocellular carcinoma
Combination therapy in the treatment of chronic viral hepatitis and prevention of hepatocellular carcinoma
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DOI：
10.1016/s1567-5769(03)00012-2
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发表时间：
2003-08-01
影响因子：
5.6
通讯作者：
Garaci, E
中科院分区：
文献类型：
--
作者：
Rasi, G;Pierimarchi, P;Garaci, E
慢性B和C型肝炎病毒（HBV和HCV）的治疗仍然令人失望，这两种病毒是肝硬化和肝癌的主要原因。干扰素和拉米夫定是注册的治疗慢性HBV的药物，但对HBeAg阴性的患者几乎没有效果，并且由于病毒变异而产生耐药是拉米夫定的规律。干扰素和利巴韦林代表慢性HCV的标准治疗，但不到一半的感染人群有资格接受这种治疗，不到一半的治疗患者将经历持续的反应。迄今为止，还没有一种新药显示出克服这种令人沮丧的局面的潜力。因此，联合策略是目前最有效的方法，以提高慢性HBV和HCV感染的应答率，随后减少发生肝细胞癌（HCC）的患者数量。胸腺素α 1与干扰素或抗病毒药物的组合是目前最有前途的选择，但应探索无毒的免疫调节剂，如口服MIMP。本文综述了目前治疗的困难和使用胸腺肽α 1联合治疗HBV和HCV的基本原理。(C)出版社：Elsevier Science B.V.
Treatment of chronic hepatitis B and C viruses (HBV and HCV) is still disappointing, and both are the major causes of liver cirrhosis and hepatocarcinoma. Interferon and lamivudine are the registered drugs for chronic HBV but are scarcely effective on HBeAg-negative patients, and resistance due to virus mutation is the rule with lamivudine. Interferon and ribavirine represent the standard treatment for chronic HCV but less than the half of the infected population is eligible for this treatment and less of the half of treated patients will experience a sustained response. No single new drug to date has shown the potential to overcome this dismal picture. Combined strategies are thus the currently most available approach to improve the response rate of chronic HBV and HCV infection, with a subsequent decrease in the number of patients developing hepatocellular carcinoma (HCC). Combination of thymosin alpha 1 with interferon or antiviral agents is currently the most promising option, but nontoxic immunomodulants, such as oral MIMP, should be explored. This review focuses on the difficulties with current therapy and the rationale for use of combination therapy with thymosin a 1 for both HBV and HCV therapies. (C) 2003 Published by Elsevier Science B.V.