Department of Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California 94121, USA.
Am J Gastroenterol. 2010 May;105(5):989-1004; quiz 988, 1005. doi: 10.1038/ajg.2009.726. Epub 2010 Jan 19.
Therapies for hepatitis B virus (HBV) have continued to evolve, and new therapies for hepatitis C virus (HCV) will soon be available in clinical practice. These medications for hepatitis C will mark the first time that direct antivirals that target HCV functions have been used. When such drugs are used as single agents, previously existing mutants with reduced susceptibility to them are rapidly selected. The relationship between these drug-resistant mutants and "wild-type" virus is unclear, but resistant strains likely have the potential to maintain the progression of liver disease despite successful treatment of "wild-type" virus. Resistant HBV and now HCV are already a clinical problem. The same issue was recognized very early in the development of therapy against HIV, with azidothymidine-resistant mutants detected within the first weeks of therapy. Clinical investigation and a progressive understanding of the pathogenesis of the disease overcame this challenge and led to the substantial and durable benefits of antiretroviral therapy that are evident today. To bring experts from the fields of HIV and viral hepatitis virology and therapy together for interactive discussions about how to apply the lessons from HIV to the further development of viral hepatitis therapy, the American Association for the Study of Liver Diseases held a single-topic conference entitled "Viral Hepatitis Therapy: Lessons to be Learned From HIV" on 24-26 July 2008. This article summarizes that conference.
乙型肝炎病毒（HBV）的治疗方法不断发展，新的丙型肝炎病毒（HCV）治疗方法很快将在临床实践中应用。这些丙型肝炎药物将标志着首次使用针对 HCV 功能的直接抗病毒药物。当这些药物单独使用时，以前存在的对它们敏感性降低的突变体很快就会被选择出来。这些耐药突变体与“野生型”病毒之间的关系尚不清楚，但耐药株可能有潜力在成功治疗“野生型”病毒的情况下继续发展为肝病。耐药 HBV 和现在的 HCV 已经是一个临床问题。在针对 HIV 的治疗开发早期就认识到了同样的问题，在治疗的第一周内就检测到了齐多夫定耐药突变体。临床研究和对疾病发病机制的逐步了解克服了这一挑战，带来了今天显而易见的抗逆转录病毒治疗的实质性和持久益处。为了让来自 HIV 和病毒性肝炎病毒学和治疗领域的专家就如何将 HIV 的经验教训应用于病毒性肝炎治疗的进一步发展进行互动讨论，美国肝病研究协会于 2008 年 7 月 24 日至 26 日举办了一次专题会议，题为“病毒性肝炎治疗：从 HIV 中吸取的教训”。本文总结了该会议的内容。
