Hoefs John, Aulakh Vikramjit S
Division of Gastroenterology and Hepatology, H.H. Chao Comprehensive Digestive Disease Center UCI Medical Center, Orange, CA, USA.
Int J Med Sci. 2006;3(2):69-74. doi: 10.7150/ijms.3.69. Epub 2006 Apr 1.
The mainstay of treatment of chronic hepatitis C is pegylated interferon combined with ribavirin and more than 50% of naïve patients will have viral cure with either 6 months (genotypes 2 and 3) or 12 months (genotypes 1,4, and 6) with the initial treatment. However, populations have been defined that respond less well to routine treatment including African Americans, immune suppressed populations, obese patients and cirrhotic patients. These types of patients are enriched in groups of patients who are non-responders to treatment. This article discusses viral kinetics that may impact treatment response, strategies to maximize treatment effectiveness in these populations and the treatment of non-responders in general. Early viral kinetics can be used to define response or non-response and these results can be used to modify subsequent treatment length and dose.
慢性丙型肝炎治疗的主要方法是聚乙二醇化干扰素联合利巴韦林，超过50%的初治患者在接受6个月（基因2型和3型）或12个月（基因1型、4型和6型）的初始治疗后可实现病毒清除。然而，已经明确了一些对常规治疗反应较差的人群，包括非裔美国人、免疫抑制人群、肥胖患者和肝硬化患者。这些类型的患者在治疗无反应者群体中占比更高。本文讨论了可能影响治疗反应的病毒动力学、在这些人群中最大化治疗效果的策略以及一般无反应者的治疗。早期病毒动力学可用于定义反应或无反应，这些结果可用于调整后续治疗时长和剂量。
