Can J Gastroenterol Hepatol. 2015 Jan-Feb;29(1):19-34. doi: 10.1155/2015/692408. Epub 2015 Jan 13.
Chronic hepatitis C remains a significant medical and economic burden in Canada, affecting nearly 1% of the population. Since the last Canadian consensus conference on the management of chronic hepatitis C, major advances have occurred that warrant a review of recommended management approaches for these patients. Specifically, direct-acting antiviral agents with dramatically improved rates of virological clearance compared with standard therapy have been developed and interferon-free, all-oral antiviral regimens have been approved. In light of this new evidence, an update to the 2012 Canadian Association for the Study of the Liver consensus guidelines on the management of hepatitis C was produced. The present document reviews the epidemiology of hepatitis C in Canada, preferred diagnostic testing approaches and recommendations for the treatment of chronically infected patients with the newly approved antiviral agents, including those who have previously failed peginterferon and ribavirin-based therapy. In addition, recommendations are made regarding approaches to reducing the burden of hepatitis C in Canada.
慢性丙型肝炎在加拿大仍是一个重大的医学和经济负担，影响近 1%的人口。自上次加拿大慢性丙型肝炎管理共识会议以来，已经取得了重大进展，需要重新评估这些患者的推荐管理方法。具体而言，与标准治疗相比，具有显著提高病毒学清除率的直接作用抗病毒药物已经开发出来，无干扰素、全口服抗病毒方案已经获得批准。鉴于这一新证据，对 2012 年加拿大肝脏研究协会关于丙型肝炎管理的共识指南进行了更新。本文件回顾了加拿大丙型肝炎的流行病学，首选的诊断检测方法以及对新批准的抗病毒药物治疗慢性感染患者的建议，包括那些以前接受过聚乙二醇干扰素和利巴韦林治疗失败的患者。此外，还就如何减轻加拿大丙型肝炎负担提出了建议。
