Jafari Atefeh, Khalili Hossein, Izadpanah Mandana, Dashti-Khavidaki Simin
Tehran University of Medical Sciences, Department of Clinical Pharmacy, Faculty of Pharmacy , Tehran , Iran.
Expert Opin Drug Saf. 2015 May;14(5):713-31. doi: 10.1517/14740338.2015.1019461. Epub 2015 Mar 26.
There are several clinical trials and prospective studies which support the use of direct-acting antiviral agents (DAAs) in hepatitis C virus (HCV)-coinfected patients. In this review, the safety of DAAs in HCV patients coinfected with hepatitis B virus (HBV) or HIV has been evaluated.
All available prospective studies, clinical trials and congress abstracts in the English language that assessed the safety and efficacy of DAAs in HCV coinfections have been considered.
The newer DAAs in the treatment of HCV/HIV-coinfected patients resolved major limitations of the first-generation protease inhibitors including complex dosing, poor tolerability and interactions with antiretroviral drugs. There are not yet enough data regarding the safety and efficacy of DAAs in some coinfected patients with comorbidities, nor for pregnant, lactating or pediatric patients. Evaluating the safety and efficacy of these agents in these subgroups with HCV coinfection is recommended for future studies. The role of new direct-acting antiviral-based therapy for the treatment of patients with HCV/HBV coinfection remains to be evaluated.
有多项临床试验和前瞻性研究支持在丙型肝炎病毒（HCV）合并感染患者中使用直接抗病毒药物（DAA）。在本综述中，已对DAA在合并乙型肝炎病毒（HBV）或人类免疫缺陷病毒（HIV）感染的HCV患者中的安全性进行了评估。
已考虑所有以英文发表的评估DAA在HCV合并感染中安全性和有效性的前瞻性研究、临床试验和会议摘要。
用于治疗HCV/HIV合并感染患者的新型DAA解决了第一代蛋白酶抑制剂的主要局限性，包括给药复杂、耐受性差以及与抗逆转录病毒药物的相互作用。对于一些合并其他疾病的合并感染患者、孕妇、哺乳期妇女或儿科患者，关于DAA安全性和有效性的数据仍然不足。建议未来的研究评估这些药物在这些HCV合并感染亚组中的安全性和有效性。基于新型直接抗病毒药物的疗法在HCV/HBV合并感染患者治疗中的作用仍有待评估。
