Current and future therapies of hepatitis C.
Current and future therapies of hepatitis C.
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DOI：
10.1016/s1089-3261(05)70169-0
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发表时间：
2001-05-01
影响因子：
5.1
通讯作者：
McHutchison, J G
中科院分区：
文献类型：
--
作者：
Shad, J A;McHutchison, J G
随着慢性丙型肝炎治疗的最新进展，转氨酶水平升高、血清中可检测到 HCV RNA 以及慢性炎症的患者成为治疗的候选者。最好的初始治疗是干扰素加利巴韦林，40% 的患者获得持续缓解率。治疗持续时间应根据 HCV 基因型而定（基因型 1 为 48 周；其他基因型为 24 周）。应在第 24 周测量血清 HCV RNA，以评估基因 1 型感染患者的反应并指导进一步治疗。不适合联合治疗的患者可以采用干扰素单药治疗。干扰素加利巴韦林的副作用、剂量调整和停药通常更常见，但可以通过密切随访和仔细监测来控制。随着治疗的快速发展，新疗法需要根据 HCV 基因型和病毒载量特征进行仔细的前瞻性评估。治疗建议可能每隔几年就会改变，新的方法可能为大多数丙型肝炎患者提供有效的治疗。
With recent advances in the treatment of chronic hepatitis C, patients with elevated aminotransferase levels, detectable HCV RNA in the serum, and chronic inflammation are candidates for therapy. The best initial therapy is interferon plus ribavirin, achieving a sustained response rate in 40% of patients. The duration of therapy should be based on HCV genotype (48 weeks for genotype 1; 24 weeks for other genotypes). Serum HCV RNA should be measured at week 24 to assess response and guide further therapy in patients with genotype 1 infection. Patients unsuitable for combination therapy can be treated with interferon monotherapy. Side effects, dose modification and discontinuation are generally more frequent with interferon plus ribavirin, but can be managed with close follow-up and careful monitoring. With rapid developments in treatment, new therapies will require careful prospective evaluation according to HCV genotype and viral-load characteristics. Recommendations for therapy will probably change every few years, and novel approaches may provide effective therapy for most patients with hepatitis C.