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日本慢性丙型肝炎患者的天然β干扰素治疗

Natural interferon-beta treatment for patients with chronic hepatitis C in Japan.

作者信息

Sasaki Reina, Kanda Tatsuo, Nakamoto Shingo, Haga Yuki, Nakamura Masato, Yasui Shin, Jiang Xia, Wu Shuang, Arai Makoto, Yokosuka Osamu

机构信息

Reina Sasaki, Tatsuo Kanda, Shingo Nakamoto, Yuki Haga, Masato Nakamura, Shin Yasui, Xia Jiang, Shuang Wu, Makoto Arai, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan.

出版信息

World J Hepatol. 2015 May 18;7(8):1125-32. doi: 10.4254/wjh.v7.i8.1125.

Abstract

Chronic hepatitis C virus (HCV) infection can cause liver cirrhosis and hepatocellular carcinoma (HCC). Several studies have demonstrated that the eradication of HCV reduces the occurrence of HCC. In Japan, as many people live to an advanced age, HCV-infected patients are also getting older, and the age at HCC diagnosis has also increased. Although older HCV-infected patients have a risk of developing HCC, the treatment response to peginterferon-alpha plus ribavirin therapy is relatively poor in these patients because of drop-out or discontinuation of this treatment due to adverse events. It is established that the mechanism of action between interferon-alpha and interferon-beta is slightly different. Short-term natural interferon-beta monotherapy is effective for patients with acute hepatitis C and patients infected with HCV genotype 2 and low viral loads. Natural interferon-beta plus ribavirin for 48 wk or for 24 wk are also effective for some patients with HCV genotype 1 or HCV genotype 2. Natural interferon-beta plus ribavirin has been used for certain "difficult-to-treat" HCV-infected patients. In the era of direct-acting anti-virals, natural interferon-beta plus ribavirin may be one of the therapeutic options for special groups of HCV-infected patients. In the near future, signal transduction pathways of interferon-beta will inform further directions.

摘要

慢性丙型肝炎病毒(HCV)感染可导致肝硬化和肝细胞癌(HCC)。多项研究表明,清除HCV可降低HCC的发生率。在日本,由于许多人寿命延长,HCV感染患者的年龄也在增大,HCC诊断时的年龄也有所增加。尽管老年HCV感染患者有发生HCC的风险,但由于不良事件导致停药或中断治疗,这些患者对聚乙二醇化干扰素-α联合利巴韦林治疗的反应相对较差。已知干扰素-α和干扰素-β的作用机制略有不同。短期天然干扰素-β单药治疗对急性丙型肝炎患者以及感染HCV基因2型且病毒载量低的患者有效。天然干扰素-β联合利巴韦林治疗48周或24周对部分HCV基因1型或HCV基因2型患者也有效。天然干扰素-β联合利巴韦林已用于某些“难治性”HCV感染患者。在直接抗病毒药物时代,天然干扰素-β联合利巴韦林可能是特殊HCV感染患者群体的治疗选择之一。在不久的将来,干扰素-β的信号转导途径将为进一步的研究方向提供信息。

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