Department of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen, UK.
Aliment Pharmacol Ther. 2012 Mar;35(6):647-62. doi: 10.1111/j.1365-2036.2012.04992.x. Epub 2012 Feb 1.
The nonstructural 3 serine protease inhibitors (PIs), boceprevir and telaprevir, represent the first in a new generation of directly acting antivirals against genotype 1 hepatitis C (HCV) infection. When used in combination with pegylated interferon and ribavirin, these drugs greatly improve sustained virological response rates in both treatment-naïve patients and patients who have had previous virological failure on treatment. However, the addition of these new agents will increase the complexity of therapeutic regimens, the rates of side-effects and costs.
To review concisely the current evidence and to suggest current best practice, for the use of telaprevir and boceprevir in the management of chronic genotype 1 HCV infection.
These guidelines for the use of boceprevir and telaprevir have been formulated following extensive review of the current literature, are based on the consensus opinion of a panel of national experts, and have been openly discussed and debated at a national meeting of HCV care providers.
We have made recommendations on a number of the key practical issues facing HCV care providers: (i) Which patients to treat?; (ii) Standards for the provision of care; (iii) Pre-treatment considerations; (iv) Which treatment regimens to use?; (v) Stopping rules; and (vi) Management of adverse effects. Finally, we have produced suggested algorithms for the assessment and treatment of these patients.
These UK Consensus guidelines indicate the current best practice for the use of boceprevir and telaprevir in the management of genotype 1 chronic HCV infection.
非结构 3 丝氨酸蛋白酶抑制剂（PI），博赛匹韦和特拉匹韦，代表了新一代直接作用抗病毒药物治疗基因 1 型丙型肝炎（HCV）感染的开端。当与聚乙二醇干扰素和利巴韦林联合使用时，这些药物大大提高了初治患者和先前治疗中病毒学失败患者的持续病毒学应答率。然而，这些新药物的加入将增加治疗方案的复杂性、副作用和成本。
简要回顾目前的证据，并提出当前治疗慢性基因 1 型 HCV 感染的最佳实践建议，用于特拉匹韦和博赛匹韦的使用。
这些博赛匹韦和特拉匹韦使用指南是在对当前文献进行广泛回顾的基础上制定的，基于一组国家专家的共识意见，并在 HCV 护理提供者的全国会议上进行了公开讨论和辩论。
我们就 HCV 护理提供者面临的一些关键实际问题提出了建议：（i）哪些患者需要治疗？；（ii）护理提供的标准；（iii）治疗前的考虑因素；（iv）使用哪些治疗方案？；（v）停药标准；（vi）不良反应的管理。最后，我们提出了用于评估和治疗这些患者的建议算法。
这些英国共识指南表明了当前治疗基因 1 型慢性 HCV 感染的博赛匹韦和特拉匹韦的最佳实践。
