Hepatology Department, AP-HP, CRB3, Beaujon Hospital, University Paris Diderot 7 and INSERM U773, Clichy, France.
Liver Int. 2015 Jan;35 Suppl 1:56-64. doi: 10.1111/liv.12745.
There has been a revolution in the treatment of chronic hepatitis C. Several oral regimens combining direct-acting antivirals (DAAs) from different families [NS5B nucleotide inhibitors, NS5B non-nucleoside inhibitors, NS5A replication complex inhibitors and NS3/4A protease inhibitors (PI)] are under development. These regimens result in an increase in sustained virological response (SVR) rates to above 90% and reduce the duration of treatment to twelve weeks or less. As of 2015 several regimens will be approved with additive potencies, without cross-resistance and with a good safety profile. Remaining issues will include increasing screening and access to care so that HCV may become the first chronic viral infection eradicated worldwide. This review summarizes results obtained with oral DAAs combinations, that have been approved and/or have completed phase III clinical trials for HCV genotype 1 (HCV-1) treatment-naïve patients.
慢性丙型肝炎的治疗已经发生了革命性变化。几种联合使用直接作用抗病毒药物（DAAs）的口服方案（来自不同家族的 NS5B 核苷酸抑制剂、NS5B 非核苷酸抑制剂、NS5A 复制复合物抑制剂和 NS3/4A 蛋白酶抑制剂（PI））正在开发中。这些方案使持续病毒学应答（SVR）率提高到 90%以上，并将治疗时间缩短到 12 周或更短。截至 2015 年，一些方案将获得批准，具有累加作用、无交叉耐药性和良好的安全性。仍需解决的问题包括增加筛查和获得治疗的机会，以便 HCV 可能成为全球首个被根除的慢性病毒感染。本文综述了已批准和/或已完成 III 期临床试验的用于治疗初治 HCV-1 患者的口服 DAA 联合方案的结果。
