Kelleher T Barry, Afdhal Nezam
Department of Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Suite 8E, Boston, MA 02115, USA.
Curr Gastroenterol Rep. 2005 Feb;7(1):50-3. doi: 10.1007/s11894-005-0066-1.
Major progress has been made in the treatment of chronic hepatitis C virus (HCV) infection over the 18 years since Hoofnagle et al. initially documented response of non-A non-B hepatitis to interferon alfa. Current optimal therapy with pegylated interferon alfa (PEG-IFN) and ribavirin results in sustained virologic response rates of just over 50%. With an estimated 2.7 million Americans with active HCV infection, we can anticipate a large number of potential treatment failures with the current standard of care. At this time, no therapy is approved by the US Food and Drug Administration for treatment failures of PEG-IFN and ribavirin. Maintenance interferon therapy with the goal of prevention of disease progression rather than viral eradication appears to offer an option for HCV treatment failures with advanced disease. Alternative medical strategies to reduce hepatic fibrosis are also under investigation. With the relatively static number of available organs for transplantation, prevention of disease progression and decompensation is essential for an impact to be made upon the predicted rates of HCV morbidity and mortality in the next 10 to 20 years.
自霍夫纳格尔等人首次记录非甲非乙型肝炎对干扰素α的反应以来的18年里，慢性丙型肝炎病毒（HCV）感染的治疗取得了重大进展。目前聚乙二醇化干扰素α（PEG-IFN）和利巴韦林的最佳治疗方案使病毒学持续应答率略高于50%。据估计，有270万美国人体内有活跃的HCV感染，我们可以预见，按照目前的治疗标准会有大量潜在的治疗失败案例。目前，美国食品药品监督管理局尚未批准任何疗法用于治疗PEG-IFN和利巴韦林治疗失败的情况。以预防疾病进展而非根除病毒为目标的维持性干扰素治疗似乎为患有晚期疾病的HCV治疗失败患者提供了一种选择。减少肝纤维化的替代医学策略也在研究中。鉴于可用于移植的器官数量相对稳定，预防疾病进展和失代偿对于在未来10至20年内影响预计的HCV发病率和死亡率至关重要。
