Poynard Thierry, Yuen Man-Fung, Ratziu Vlad, Lai Ching Lung
Service d'Hépato-gastro-entérologie, Groupe Hospitalier Pitié-Salpêtriére, Université, Paris, France.
Lancet. 2003 Dec 20;362(9401):2095-100. doi: 10.1016/s0140-6736(03)15109-4.
More than 170 million people worldwide are chronically infected with the hepatitis C virus (HCV), which is responsible for more than 100000 cases of liver cancer per year, with similar numbers of digestive haemorrhage and ascites episodes. Major breakthroughs have been made in diagnosis and treatment, and advances in molecular biology mean that the replicative state of the virus can now be assessed. Genotype and serum viral load are useful predictors of response to treatment. The combination of pegylated interferon and ribavirin can eradicate the virus in more than 50% of patients. These antiviral treatments reduce liver fibrosis progression and can reverse cirrhosis. Unfortunately, even in developed countries, death due to hepatitis C is increasing because of inadequate detection and treatment.
全球有超过1.7亿人长期感染丙型肝炎病毒(HCV),该病毒每年导致超过10万例肝癌病例,还有数量相近的消化道出血和腹水发作病例。在诊断和治疗方面已取得重大突破,分子生物学的进展意味着现在可以评估病毒的复制状态。基因型和血清病毒载量是治疗反应的有用预测指标。聚乙二醇化干扰素和利巴韦林联合使用可使超过50%的患者根除病毒。这些抗病毒治疗可减缓肝纤维化进展,并能逆转肝硬化。不幸的是,即使在发达国家,由于检测和治疗不足,丙型肝炎导致的死亡人数也在增加。