Ohkoshi Shogo, Hirono Haruka, Yamagiwa Satoshi
Shogo Ohkoshi, Haruka Hirono, Department of Internal Medicine, School of Life Dentistry at Niigata, the Nippon Dental University, Niigata-city 951-8580, Japan.
World J Gastrointest Pharmacol Ther. 2015 Nov 6;6(4):114-9. doi: 10.4292/wjgpt.v6.i4.114.
Recently, direct antiviral agents (DAAs) have been increasingly used for the treatment of chronic hepatitis C virus (HCV) infections, replacing interferon-based regimens that have severe adverse effects and low tolerability. The constant supply of new DAAs makes shorter treatment periods with enhanced safety possible. The efficacy of DAAs for treatment of compensated liver cirrhosis (LC) is not less than that for treatment of non-cirrhotic conditions. These clinical advantages have been useful in pre- and post-liver transplantation (LT) settings. Moreover, DAAs can be used to treat decompensated HCV-induced LC in elderly patients or those with severe complications otherwise having poor prognosis. Although encouraging clinical data are beginning to appear, the actual efficacy of DAAs for suppressing disease progression, allowing delisting for LT and, most importantly, improving prognosis of patients with decompensated HCV-LC remains unknown. Case-control studies to examine the short- or long-term effects of DAAs for treatment of decompensated HCV-LC are urgently need.
近年来，直接抗病毒药物（DAAs）越来越多地用于治疗慢性丙型肝炎病毒（HCV）感染，取代了具有严重不良反应和低耐受性的基于干扰素的治疗方案。新DAAs的持续供应使得缩短治疗周期并提高安全性成为可能。DAAs治疗代偿期肝硬化（LC）的疗效不低于治疗非肝硬化情况的疗效。这些临床优势在肝移植（LT）前后的环境中很有用。此外，DAAs可用于治疗老年患者或有严重并发症、预后较差的失代偿性HCV诱导的LC。尽管令人鼓舞的临床数据开始出现，但DAAs在抑制疾病进展、允许LT除名以及最重要的是改善失代偿性HCV-LC患者预后方面的实际疗效仍然未知。迫切需要进行病例对照研究，以检验DAAs治疗失代偿性HCV-LC的短期或长期效果。
