PDF(Pubmed)
Abstract：
Hepatitis C virus still represents a major cause of morbidity and mortality worldwide. In Peru, two national practice guidelines for the management of this infection were published more than 5 years ago; however, the latest breakthroughs in the treatment make it necessary to update these guidelines. We reviewed the most recent recommendations of the international guidelines and compared them with the current Peruvian guidelines. We found major differences, such as the use of Glecaprevir/Pibrentasvir as a first-line therapy, which is contemplated in the World Health Organization guideline, and recommended by American and European guidelines, but is not considered in the Peruvian guidelines. Another crucial difference lies in the management of patients with chronic kidney disease, who are treated nowadays with a variety of direct-acting antivirals, with no restrictions on the use of Sofosbuvir-based regimens in first-world countries, an approach that has not been adopted in Peru. We believe that standardization of the recommendations of the Peruvian guidelines is imperative, including the new therapeutic strategies that have emerged in recent years. We also suggest conducting a cost effectiveness analysis in the Peruvian context to allow for the implementation of new antivirals, and to achieve a better control of hepatitis C in the country.
摘要：
丙型肝炎病毒仍然是全世界发病率和死亡率的主要原因。在秘鲁,5年多前发布了两项管理这种感染的国家实践指南；然而，治疗方面的最新突破使得有必要更新这些指南。我们回顾了国际准则的最新建议，并将其与当前的秘鲁准则进行了比较。我们发现了很大的不同,例如使用Glecaprevir/Pibrentasvir作为一线治疗，这是在世界卫生组织指南中考虑的，并由美国和欧洲指南推荐，但秘鲁指南中没有考虑。另一个关键的区别在于慢性肾脏病患者的管理，他们现在用各种直接作用的抗病毒药物治疗，在第一世界国家没有限制使用基于Sofosbuvir的方案，秘鲁尚未采用的方法。我们认为,秘鲁准则建议的标准化势在必行,包括近年来出现的新的治疗策略。我们还建议在秘鲁背景下进行成本效益分析，以便实施新的抗病毒药物，并在该国更好地控制丙型肝炎。
