直接抗病毒药物在慢性丙型肝炎特殊人群中应用的有效性、安全性评价

Efficacy and safety of using DAAs to treatment the special populations with chronic hepatitis C

慢性丙型病毒性肝炎(chronic hepatitis C, CHC)是一个全球健康问题,呈世界性流行,我国在全球范围内属于低流行区。丙型肝炎病毒(hepatitis C virus, HCV)主要经血液途径传播,静脉药物成瘾者是丙型病毒性肝炎防治的重点人群。HCV有多种基因型和基因亚型,各基因型和基因亚型在全球各地区分布具有显著差异。目前对丙型病毒性肝炎的治疗已经进入应用直接抗病毒药物(direct-acting antiviral agents, DAAs)的时代,DAAs在普通人群中的应用具有高效性和安全性,特殊人群丙肝患者在使用DAAs治疗时是否同样有效、安全一直备受关注。本文就DAAs在患有CHC的特殊人群(包括儿童和青少年、静脉药物成瘾者、HBV共感染者、HIV共感染者、慢性肾脏病共病者)中应用的最新研究进展进行综述,探讨这几类特殊人群使用DAAs治疗丙型病毒性肝炎的有效性和安全性。

Chronic hepatitis C(CHC) is a global health problem, which is prevalent all over the world. China is a low epidemic area. Hepatitis C virus(HCV) is mainly transmitted through blood, and nowadays, intravenous drug addicts are the key population for the prevention and treatment of hepatitis C. HCV has multiple genotypes and gene subtypes, and the distribution of these genotypes and gene subtypes varies significantly among the regions of the world. Nowadays, the treatment of hepatitis C has entered the era of direct-acting antiviral agents, which have high efficacy and safety in the general population. However, when special populations use direct-acting antiviral agents to treatment hepatitis C, we don’t know how its efficacy and safety will be. The special populations include children, adolescents, drug users, HCV/HBV co-infected patients, HCV/HIV co-infected patients, and patients who have comorbidity of HCV and chronic kidney disease. This review will discuss the efficacy and safety of using direct-acting antiviral agents to treat hepatitis C in these special populations.