Cleveland Clinic Lerner, College of Medicine of Case Western Reserve University, RJ Fasenmyer Chair of Clinical Immunology, Cleveland Clinic, Cleveland, Ohio , USA.
Inflammation-Immunopathology-Biotherapy Department (DHU i2B) , Sorbonne Universités, UPMC Univ Paris 06, UMR 7211 , Paris , France ; INSERM, UMR_S 959 , Paris , France ; CNRS, FRE3632 , Paris , France ; Department of Internal Medicine and Clinical Immunology , AP-HP, Groupe Hospitalier Pitié-Salpêtrière , Paris , France.
RMD Open. 2015 Feb 18;1(1):e000008. doi: 10.1136/rmdopen-2014-000008. eCollection 2015.
Hepatitis C virus (HCV) is a global pathogen and is the cause of rare but complex rheumatic complications but more commonly exists as a challenging comorbidity for patients with existing rheumatic diseases. Until recently, the standard of care of HCV has been the use of interferon-based regimens, which not only have limited effectiveness in curing the underlying viral illness but are poorly tolerated and in patients with rheumatic diseases especially problematic given their association with a wide variety of autoimmune toxicities. Numerous and other more effective and better tolerated regimens are rapidly emerging incorporating direct acting antiviral agents that do not require the use of interferon, that is, interferon free. The potential of interferon free treatment of HCV makes screening for this comorbidity more important than ever. Rheumatologists need to be knowledgeable about these therapeutic advances and partner with hepatologists to craft the most efficacious and toxicity-free regimes possible.
丙型肝炎病毒(HCV)是一种全球性病原体,可引起罕见但复杂的风湿性并发症,但更常见的是作为现有风湿性疾病患者的一种具有挑战性的合并症存在。直到最近,HCV 的标准治疗方法一直是使用基于干扰素的方案,这些方案不仅在治愈潜在病毒疾病方面效果有限,而且耐受性差,在患有风湿性疾病的患者中尤其成问题,因为它们与多种自身免疫毒性有关。许多其他更有效和更好耐受的方案正在迅速出现,包括不使用干扰素的直接作用抗病毒药物,即无干扰素。无干扰素治疗 HCV 的潜力使得筛查这种合并症比以往任何时候都更加重要。风湿病学家需要了解这些治疗进展,并与肝病学家合作,制定最有效和无毒的方案。