直接抗病毒药物治疗丙型肝炎的毒副作用、药物相互作用及安全性

Adverse effects,drug interactions,and safety of direct-acting antiviral agents in treatment of hepatitis C

近年来,直接抗病毒药物(DAA)在丙型肝炎的治疗中取得了极大的成功,迅速取代了IFN/利巴韦林的地位。然而,由于这类药物上市不久,关于其毒副作用、与其他药物的相互作用,以及在合并其他严重慢性疾病时应用的安全性,目前了解尚不充分。多项大型临床试验研究结果显示,在各类人群中,DAA均表现出良好的安全性,严重毒副作用罕见,但药物相互作用需要引起重视;DAA治疗方案中加入利巴韦林或延长DAA治疗时间,不会增加患者治疗收益,但可导致不良反应增多。另外,DAA治疗的同时,不应忽视HCV已经造成的肝损伤,需要继续给予相关治疗措施。

In recent years,direct-acting antiviral agents（DAAs） have achieved great success in the treatment of hepatitis C and have replaced interferon/ribavirin. However,since DAAs were launched not long ago,there lacks sufficient knowledge of their toxic and side effects,interactions with other drugs,and safety in patients complicated by other serious chronic diseases. The results of many large-scale clinical trials show that DAAs have good safety in different populations and serious toxic and side effects are rare,but drug interactions need to be taken seriously. The addition of ribavirin in DAA regimen or prolongation of DAA treatment does not increase patients＇ benefits and may cause more adverse events. Moreover,at the same time of DAA treatment,liver injury caused by HCV cannot be neglected,and continuous treatment should be given.