Sundaram Vinay, Kowdley Kris V
a Department of Medicine and Comprehensive Transplant Center , Cedars-Sinai Medical Center , Los Angeles , CA , USA.
Expert Rev Gastroenterol Hepatol. 2016;10(1):13-20. doi: 10.1586/17474124.2016.1116937. Epub 2015 Dec 2.
Chronic hepatitis C virus (HCV) infection is one of the most common etiologies of liver-related mortality throughout the world. Traditionally, therapy has been focused on pegylated interferon in combination with ribavirin, with clinical trials demonstrating that HCV genotype 1 had the lowest response rate (40-50%), while genotype 3 had an intermediate response rate (60-70%). Recently, significant advances have been made with all-oral direct-acting antiviral (DAA) therapy, which have significantly improved cure rates for HCV genotype 1. Accordingly, HCV genotype 3 is now potentially the most difficult to treat. One of the most potent DAA medications is sofosbuvir, a pan-genotypic nucleotide analogue that inhibits the NS5B polymerase of HCV. Daclatasvir, a pan-genotypic inhibitor of the HCV NS5A replication complex, was recently approved in the United States for treatment of HCV genotype 3 in conjunction with sofosbuvir. This combination may provide a powerful tool in the treatment of HCV genotype 3.
慢性丙型肝炎病毒（HCV）感染是全球与肝脏相关死亡的最常见病因之一。传统上，治疗一直集中于聚乙二醇化干扰素联合利巴韦林，临床试验表明，HCV 1型的应答率最低（40 - 50%），而3型的应答率处于中等水平（60 - 70%）。最近，全口服直接抗病毒（DAA）疗法取得了重大进展，显著提高了HCV 1型的治愈率。因此，HCV 3型目前可能是最难治疗的。最有效的DAA药物之一是索磷布韦，一种泛基因型核苷酸类似物，可抑制HCV的NS5B聚合酶。盐酸达拉他韦是一种HCV NS5A复制复合体的泛基因型抑制剂，最近在美国被批准与索磷布韦联合用于治疗HCV 3型。这种联合用药可能为HCV 3型的治疗提供一个有力工具。
