Andronescu D, Diaconu S, Tiuca N, Purcarea R M, Andronescu C I
"Carol Davila" University of Medicine and Pharmacy, Gastroenterology Department, Emergency University Hospital, Bucharest.
"Carol Davila" University of Medicine and Pharmacy, "Dr. Carol Davila" Clinical Nephrology Hospital, Bucharest, Romania.
J Med Life. 2014 Mar 15;7(1):31-6. Epub 2014 Mar 25.
Combination therapy with pegylated interferon alfa (PEG-IFN alfa) and the nucleoside analogue ribavirin is the current standard of care in patients infected with hepatitis C virus (HCV). Patients with HCV genotype 1 have a much less favorable response to therapy and are treated for 12 months, compared with patients infected with genotypes 2 and 3, in whom a 6-month course of therapy is sufficient. If viremia is present after 6 months, additional therapy has a negligible benefit, and treatment should be stopped in all patients regardless of the viral genotype. With HIV coinfection, all patients with a response to therapy at the end of 6 months should receive an additional 6 months of combination therapy regardless of the genotype. Patients with acute HCV infection should be treated for 6 months. The addition of protease inhibitors to the combination of PEG-IFN alfa and ribavirin is becoming the new standard of care for the treatment of chronic HCV infection. Regimens that include a protease inhibitor significantly improve sustained virologic response rates in patients with genotype 1 HCV infection.
聚乙二醇化干扰素α（PEG-IFNα）与核苷类似物利巴韦林联合治疗是目前丙型肝炎病毒（HCV）感染患者的标准治疗方案。与感染2型和3型HCV的患者相比，感染1型HCV的患者对治疗的反应较差，需接受12个月的治疗，而感染2型和3型HCV的患者6个月的疗程就足够了。如果6个月后仍存在病毒血症，额外治疗的获益微乎其微，所有患者均应停止治疗，无论病毒基因型如何。对于合并HIV感染的患者，所有在6个月末对治疗有反应的患者均应再接受6个月的联合治疗，无论基因型如何。急性HCV感染患者应接受6个月的治疗。在PEG-IFNα和利巴韦林联合治疗中添加蛋白酶抑制剂正成为慢性HCV感染治疗的新标准。包含蛋白酶抑制剂的治疗方案可显著提高1型HCV感染患者的持续病毒学应答率。
