Thitinan Sumalee, McConville Jason T
College of Pharmacy, The University of Texas at Austin, Austin, TX 78712-0231, USA.
Int J Pharm. 2009 Mar 18;369(1-2):121-35. doi: 10.1016/j.ijpharm.2008.11.027. Epub 2008 Dec 3.
Hepatitis C virus (HCV) infections are the most common chronic blood-borne viral infections in the world. The prevalence of HCV infections varies significantly by race or ethnicity, with a high prevalence of the disease displayed in the Hispanic population. Additionally, Hispanics with chronic HCV have also more advanced hepatic fibrosis and faster liver fibrosis progression rates than either African Americans or Caucasians. Furthermore, a higher prevalence of cirrhosis and extent of mortality from liver cirrhosis is also observed in the Hispanic population compared with other groups. Current recommendations for treatment of hepatitis C are interferon alpha (IFNalpha)-based monotherapy and combination of IFNalpha preparations with ribavirin. Future treatment regimens will still be based on IFNalpha therapy with or without other effective antiviral agents, currently under investigation. However, there are some inherent limitations, mainly their relative short systemic circulation lifespan, and their unwanted effects on some non-target tissues. New research focuses on the development of novel modified interferon molecules which demonstrate reduced side effects and extended systemic circulation time, which can ultimately provide greater efficacy. Alternative routes for IFNalpha delivery, such as oral delivery, demonstrate challenging but promising areas of research for improving future patient compliance.
丙型肝炎病毒（HCV）感染是全球最常见的慢性血源性病毒感染。HCV感染的患病率因种族或族裔的不同而有显著差异，西班牙裔人群中该疾病的患病率较高。此外，患有慢性HCV的西班牙裔人群比非裔美国人或白种人有更严重的肝纤维化，且肝纤维化进展速度更快。此外，与其他群体相比，西班牙裔人群中肝硬化的患病率和肝硬化死亡率也更高。目前丙型肝炎的治疗建议是以α干扰素（IFNα）为基础的单一疗法以及IFNα制剂与利巴韦林的联合疗法。未来的治疗方案仍将基于IFNα疗法，无论是否联合其他正在研究的有效抗病毒药物。然而，这些疗法存在一些固有局限性，主要是它们相对较短的全身循环寿命，以及对某些非靶组织的不良影响。新的研究重点是开发新型修饰干扰素分子，这些分子显示出副作用减少和全身循环时间延长，最终可提供更高的疗效。IFNα的替代给药途径，如口服给药，对改善未来患者的依从性而言是具有挑战性但前景广阔的研究领域。
