慢性丙型肝炎治疗新纪元——口服逆转录酶和蛋白酶抑制剂的临床应用

New era for management of HCV:Oral combination of a nucleoside polymerase inhibitor and protease inhibitor

慢性丙型肝炎患者经过聚乙二醇干扰素(PEG-IFN)联合利巴韦林(RBV)治疗后,多数患者可以获得临床治愈,即停药随访6个月后病毒仍然检测不到,且疾病不再进展。然而,还有相当一部分患者因为不能耐受IFN或RBV而未完成标准治疗,或对治疗完全无应答,或停药后复发,或由于疾病发现较晚而失去了抗病毒治疗的时机。因此,在临床上仍然需要新的抗病毒药物,或者和IFN联合治疗,或者单独治疗。本文将就近年来研发的口服逆转录酶和蛋白酶抑制剂的直接抗病毒药物的临床研究和应用作一综述。

Chronic hepatitis C, a curable disease with pegylated interferon alfa （ PEG - IFN ） plus ribavirin （ RBV ）, has been associated with rates of sustained virological response （SVR） ,which is defined as HCV RNA negative at 24 weeks after cessation of treatment and the disease is not or slow progressive. While some patients have lower tolerability towards either 1FN or RBV due to side effects, or null non - response to treatment, or relapse after cessation of treatment, or in late stage of the disease. Many direct - acting antiviral drugs are being developed that are aimed at various HCV targets. The successful development of an oral interferon - free direct - acting antiviral drug combi- nation treatment would fill an unmet medical need, and potentially change the existing standard of care for HCV.