Department of Internal Medicine I, University of Bonn, Bonn, Germany.
Semin Liver Dis. 2012 May;32(2):130-7. doi: 10.1055/s-0032-1316468. Epub 2012 Jul 3.
Almost 10 years ago clinicians started to note the first cases of an outbreak of acute hepatitis C (AHC) infections among human immunodeficiency virus- (HIV-) positive men who have sex with men (MSM) in Europe, soon followed by similar reports from the United States and Australia. In the absence of randomized controlled treatment trials in AHC, coinfection expert consensus recommendations based upon published data from uncontrolled clinical and cohort studies give guidance on best clinical management. Pegylated interferon in combination with weight-adapted ribavirin is still recommended as the treatment of choice for all HCV genotypes. For patients developing a rapid virologic response, treatment duration of 24 weeks is recommended. If antiviral therapy was initiated within 24 weeks after diagnosis, high sustained virologic response rates of 60 to 80% have been observed. Prevention and screening efforts along with early anti-HCV therapy have to be intensified to allow for control of viral dissemination as the current epidemic of AHC particularly among MSM is still ongoing.
大约 10 年前，临床医生开始注意到在欧洲，艾滋病毒（HIV）阳性的男男性行为者（MSM）中首次出现丙型肝炎（AHC）急性感染爆发的病例，随后美国和澳大利亚也出现了类似的报告。在 AHC 缺乏随机对照治疗试验的情况下，基于未对照的临床和队列研究的已发表数据，合并感染专家共识建议为最佳临床管理提供指导。聚乙二醇干扰素联合体重适应利巴韦林仍然被推荐作为所有 HCV 基因型的治疗选择。对于快速病毒学应答的患者，建议治疗 24 周。如果在诊断后 24 周内开始抗病毒治疗，则可观察到高达 60%至 80%的高持续病毒学应答率。必须加强预防和筛查工作以及早期抗 HCV 治疗，以控制病毒传播，因为目前 AHC 的流行，特别是在 MSM 中仍在继续。
