丙肝病毒药物选择压与基因遗传突变

Selective pressure of DAA against HCV and relevant resistance variants

丙型肝炎病毒(hepatitis C virus,HCV)是单股RNA病毒,在药物压力下极易变异。近年来,随着直接作用的抗病毒药物(direct-acting antiviral agents,DAA)的临床应用和更新换代,丙肝患者的持续病毒应答率(sustained virological response,SVR)大大提高。然而,DAA压力下产生的耐药相关变异株(resistance associated variants,RAV)也不断出现并被选择出来,严重影响DAA治疗效果或致治疗失败及耐药株流行。介绍了DAA相关耐药基因产生的来源与分类,并总结了近年来相关耐药突变的数据。

Hepatitis C virus（HCV） is a single-strand RNA virus which is easy to produce variants under pressure of antiviral drug. Recently, sustained virological response（SVR） rate in HCV patients has been increased largely thanks to the rapid development of direct-acting antiviral agents（DAA）. However, resistance associated variants（RAV） have been selected under the pressure of DAA, which reduce the antiviral efficiency or causes treatment failure of DAA-based therapies. In this article, we introduce the origin and prevalence of RAV, and summarize relevant data of the variants according to their classification.