背景:在过去的二十年中,用于管理丙型肝炎病毒(HCV)感染的治疗选择迅速发展。从而提高治愈率。新型治疗剂是研究界非常感兴趣的领域,其中一些药物在临床上显示出希望。
目的:为了评估和提出使用新型治疗药物治疗HCV的现有证据,更新以前的准则。
方法:所有2期和3期研究,以及来自国际肝病学会议的摘要介绍被确定和审查为合适的纳入,基于HCV新疗法的研究。治疗-幼稚和有经验的个人,以及肝硬化和共感染的个体被包括在内。
结果:索非布韦,simeprevir和faldaprevir,还有聚乙二醇干扰素和利巴韦林,在慢性HCV感染的治疗中发挥作用。精确的治疗方案在很大程度上取决于患者的特征,患者和医生的偏好,和成本含义。
结论:近年来,慢性HCV的治疗方法有了显著的发展。无干扰素方案现在是可能的,而不会影响持续的病毒应答率。关于哪种方案最合适的决定是多方面的,基于功效,安全性和成本。
BACKGROUND: Therapeutic options for the management of hepatitis C virus (HCV) infection have evolved rapidly over the past two decades, with a consequent improvement in cure rates. Novel therapeutic agents are an area of great interest in the research community, with a number of these agents showing promise in the clinical setting.
OBJECTIVE: To assess and present the available evidence for the use of novel therapeutic agents for the treatment of HCV, updating previous
guidelines.
METHODS: All Phase 2 and 3 studies, as well as abstract presentations from international Hepatology meetings were identified and reviewed for suitable inclusion, based on studies of new therapies in HCV. Treatment-naïve and experienced individuals, as well as cirrhotic and co-infected individuals were included.
RESULTS: Sofosbuvir, simeprevir and faldaprevir, along with pegylated interferon and ribavirin, have a role in the treatment of chronic HCV infection. The precise regimens are largely dependent on the patient characteristics, patient and physician preferences, and cost implication.
CONCLUSIONS: Therapies for chronic HCV have evolved dramatically in recent years. Interferon-free regimens are now possible without compromise in the rate of sustained viral response. The decision as to which regimen is most appropriate is multifactorial, and based on efficacy, safety and cost.