慢性丙型肝炎直接抗病毒药物的相互作用

Drug-drug interaction of direct-acting antivirals in treatment of chronic hepatitis C

随着直接抗病毒药物(DAA)在治疗丙型肝炎中的成功应用,药物之间相互作用(DDI)的临床管理成为了丙型肝炎治疗领域值得关注的热点之一。大部分DAA通过肝脏和(或)肠道的细胞色素P450酶系或转运蛋白,与合并用药发生DDI。目前,欧洲肝病学会发布了慢性丙型肝炎DAA相互作用的推荐意见,涵盖抗HIV逆转录病毒药物、降脂药/心血管药物、免疫抑制剂和中枢神经系统成瘾药物等。临床医师在制订DAA治疗方案时,应该对DDI的风险进行严密评估和监测,以最大程度降低或避免抗病毒治疗在内的相关治疗失败或不良反应发生。

With the successful application of direct-acting antivirals（DAAs） in the treatment of hepatitis C,clinical management of drug-drug interaction（DDI） has become a hot topic in this field.Most DAAs develop DDI with other drugs administered at the same time via cytochrome P450 or transporters in the liver and/or the intestine.At present,European Association for the Study of the Liver has published the recommendations on DDI of DAAs in the treatment of chronic hepatitis C,which covers HIV antiretrovirals,lipid-lowering drugs,cardiovascular drugs,immunosuppressants,and addictive drugs for the central nervous system.When developing the regimens for DAA treatment,clinicians should closely assess and monitor the risk of DDI,in order to reduce or avoid treatment failure or adverse reactions during antiviral therapy.