直接抗病毒药物治疗慢性丙型肝炎肝硬化的研究进展

Research progress of direct-acting antiviral drugs in the treatment of chronic hepatitis C-related cirrhosis

慢性丙型肝炎是由丙型肝炎病毒感染引起的一种病毒性肝炎,可进一步进展为肝硬化、肝衰竭、肝细胞癌,甚至死亡。目前尚未有预防性的疫苗,因此,预防感染及安全有效的药物治疗是目前应对丙型肝炎病毒感染最有效的应对策略。自2014年以来,直接抗病毒药物的临床应用对慢性丙型肝炎的治疗带来了革命性的变化。直接抗病毒药物具有极佳的清除丙型肝炎病毒效果,且耐受性、安全性良好,可显著改善肝功能、代谢障碍及免疫功能障碍等。然而有研究指出,直接抗病毒药物在治疗慢性丙型肝炎肝硬化时即使清除了丙型肝炎病毒,仍有相当比例的患者出现严重肝衰竭、肝细胞癌甚至肝病相关死亡,所以直接抗病毒药物治疗慢性丙型肝炎肝硬化仍有些问题需要进一步探讨。现综述直接抗病毒药物对慢性丙型肝炎肝硬化患者的研究进展,为慢性丙型肝炎肝硬化患者的治疗提供有意义的参考。

Chronic hepatitis C is a kind of viral hepatitis caused by hepatitis C virus infection,which can further progress to cirrhosis,liver failure,hepatocellular carcinoma,and even death.Presently,there is no preventive vaccine yet.Therefore,preventing infection and safe and effective drug treatment are currently the most effective strategies for dealing with hepatitis C virus infection.Since 2014,the clinical application of direct-acting antiviral drugs has brought revolutionary changes to the treatment of chronic hepatitis C.Direct-acting antiviral drugs have an excellent hepatitis C virus clearance effect,are well tolerated,have a good safety profile,and can significantly improve liver function,metabolic disorders,immune dysfunction,etc.However,some studies have pointed out that even if the hepatitis C virus is cleared during the treatment of chronic hepatitis C-related cirrhosis with direct-acting antiviral drugs,a considerable proportion of patients still have severe liver failure,hepatocellular carcinoma,and even liver disease-related death,so there are still some problems in the treatment of chronic hepatitis C-related cirrhosis with direct-acting antiviral drugs that need to be further explored.This article reviews the research progress of direct-acting antiviral drugs so as to provide meaningful references for the treatment of patients with chronic hepatitis C-related cirrhosis.