New treatments for chronic hepatitis C.
New treatments for chronic hepatitis C.
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DOI：
10.3350/kjhep.2010.16.3.263
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Chung RT
中科院分区：
文献类型：
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作者：
Jang JY;Chung RT
过去 15 年来，慢性丙型肝炎的治疗方法取得了显着进展。对于感染 HCV 基因型 1 或 2/3 的患者，治疗标准 (SOC) 为聚乙二醇干扰素 alfa-2a/-2b 联合利巴韦林治疗 48 周或 24 周。治疗持续时间可以根据治疗期间的基线病毒载量和病毒学反应速度进行个体化。然而，目前的疗法存在副作用、并发症和患者耐受性差的问题。因此，迫切需要找到更好的策略来治疗这种疾病。使用针对 NS3/4A 和 NS5B 聚合酶的新型 HCV 特异性抑制剂可以改善持续病毒学应答 (SVR)。最近的试验发现，将 SOC 与蛋白酶抑制剂特拉匹韦和博普瑞韦联合使用，HCV 基因 1 型感染患者的 SVR 率分别为 61~68% 和 67~75%。几种新型HCV特异性抑制剂，例如蛋白酶抑制剂、核苷和非核苷聚合酶抑制剂以及具有抗HCV活性的非HCV特异性化合物目前正在进行临床评估。在这篇综述中，我们讨论了这些慢性丙型肝炎的新疗法。
Treatments for chronic hepatitis C has evolved significantly in the past 15 years. The standard of care (SOC) is peginterferon alfa-2a/-2b with ribavirin for 48 weeks or 24 weeks in patients infected with HCV genotype 1 or 2/3, respectively. The treatment duration can be individualized based on the baseline viral load and the speed of the virologic response during treatment. However, current therapies are associated with side effects, complications, and poor patient tolerability. Therefore, there is an urgent need to identify better strategies for treating this disease. An improved sustained virologic response (SVR) can be achieved with new HCV-specific inhibitors against NS3/4A and NS5B polymerases. Recent trials have found SVR rates in patients with HCV genotype 1 infection of 61~68% and 67~75% for combining the SOC with the protease inhibitors telaprevir and boceprevir, respectively. Several new HCV-specific inhibitors such as protease inhibitors and nucleoside and non-nucleoside polymerase inhibitors as well as non-HCV-specific compounds with anti-HCV activity are currently in clinical evaluation. In this review we discuss these new treatments for chronic hepatitis C.