Strahotin Cristina Simona, Babich Michael
Division of Gastroenterology, West Penn Allegheny Health System, 1307 Federal Street, Ste 301, Pittsburgh, PA 15212, USA.
Adv Virol. 2012;2012:267483. doi: 10.1155/2012/267483. Epub 2012 Jul 19.
Hepatitis C (HCV), a leading cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma, is the most common indication for liver transplantation in the United States. Although annual incidence of infection has declined since the 1980s, aging of the currently infected population is expected to result in an increase in HCV burden. HCV is prone to develop resistance to antiviral drugs, and despite considerable efforts to understand the virus for effective treatments, our knowledge remains incomplete. This paper reviews HCV resistance mechanisms, the traditional treatment with and the new standard of care for hepatitis C treatment. Although these new treatments remain PEG-IFN-α- and ribavirin-based, they add one of the newly FDA approved direct antiviral agents, telaprevir or boceprevir. This new "triple therapy" has resulted in greater viral cure rates, although treatment failure remains a possibility. The future may belong to nucleoside/nucleotide analogues, non-nucleoside RNA-dependent RNA polymerase inhibitors, or cyclophilin inhibitors, and the treatment of HCV may ultimately parallel that of HIV. However, research should focus not only on effective treatments, but also on the development of a HCV vaccine, as this may prove to be the most cost-effective method of eradicating this disease.
丙型肝炎（HCV）是慢性肝病、肝硬化和肝细胞癌的主要病因，是美国肝移植最常见的适应证。尽管自20世纪80年代以来感染的年发病率有所下降，但目前受感染人群的老龄化预计将导致HCV负担增加。HCV易于对抗病毒药物产生耐药性，尽管为有效治疗了解该病毒付出了巨大努力，但我们的认识仍不完整。本文综述了HCV耐药机制、传统治疗方法以及丙型肝炎治疗的新护理标准。尽管这些新疗法仍以聚乙二醇干扰素-α和利巴韦林为基础，但添加了一种新的经美国食品药品监督管理局（FDA）批准的直接抗病毒药物，特拉匹韦或博赛匹韦。这种新的“三联疗法”提高了病毒治愈率，尽管治疗失败仍有可能发生。未来可能属于核苷/核苷酸类似物、非核苷RNA依赖性RNA聚合酶抑制剂或亲环素抑制剂，HCV的治疗最终可能与HIV的治疗类似。然而，研究不仅应关注有效治疗方法，还应关注HCV疫苗的研发，因为这可能是根除这种疾病最具成本效益的方法。
