Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
J Viral Hepat. 2013 Oct;20(10):669-77. doi: 10.1111/jvh.12168.
Affecting 2-3% of the world's population, hepatitis C is a common viral infection which is a significant cause of morbidity and mortality. Hepatitis C genotype 1 is the dominant viral genotype among Western patients. For the last 20 years, in the era of interferon-based therapy, it was far more difficult to treat relative to genotypes 2 and 3. Accordingly, a significant focus of research was on new antiviral agents for the dominant genotype 1 patient. Now, as promising specific treatments are being introduced for genotype 1, the attention of clinicians and researchers has turned back to the 50-70 million patients infected with a nongenotype 1 hepatitis C. Furthermore, after recent, larger randomized trials, we have realized that genotype 2 is truly interferon sensitive while genotype 3 patients are far less successful with therapy. In this fundamentally altered landscape, genotype 3 is now potentially the most difficult to treat genotype and an area of intense research for new drug development. Herein we review the virology, natural history and the treatment of genotype 3 hepatitis C.
丙型肝炎影响全球 2-3%的人口，是一种常见的病毒感染，是发病率和死亡率的重要原因。丙型肝炎基因型 1 是西方患者中主要的病毒基因型。在过去的 20 年中，在基于干扰素的治疗时代，相对于基因型 2 和 3，它的治疗难度要大得多。因此，研究的重点主要集中在针对主要基因型 1 患者的新型抗病毒药物上。现在，随着针对基因型 1 的有希望的特定治疗方法的引入，临床医生和研究人员的注意力又回到了感染非基因型 1 丙型肝炎的 5000 万至 7000 万患者身上。此外，最近更大规模的随机试验使我们意识到，基因型 2 确实对干扰素敏感，而基因型 3 患者的治疗成功率则低得多。在这种根本性改变的情况下，基因型 3 现在可能是最难治疗的基因型，也是新药物开发的研究热点。本文综述了基因型 3 丙型肝炎的病毒学、自然史和治疗。
