[临床实践中的一项新挑战：丙型肝炎治疗中对直接作用抗病毒药物的耐药性]

[A new challenge in clinical practice: resistance to directly acting antivirals in hepatitis C treatment].

作者信息

Chen Z W, Hu P, Ren H

机构信息

Department of Infectious Diseases, Institute for Viral Hepatitis, the Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2016 Mar 20;24(3):165-9. doi: 10.3760/cma.j.issn.1007-3418.2016.03.002.

DOI:10.3760/cma.j.issn.1007-3418.2016.03.002

PMID:27095757

Abstract

Directly acting antivirals (DAAs) is a major treatment of hepatitis C virus (HCV) overseas. But DAAs resistance is getting more and more clinicians' attention. DAAs have not been approved in China to date, even though some of them are in clinical trials. However, a good knowledge of DAAs resistance is important on optimizing HCV treatment regimens, increasing sustained virological response (SVR) and decreasing treatment failure in clinical. In this review, DAAs resistance mechanism and virologic barrier to resistance, the prevalence of pre-existing DAAs resistance-associated variants (RAVs), the impact of RAVs on treatment outcome, the options of treatment regimens after resistance and drug resistance testing are discussed, hoping to provide some help for DAAs' standardized treatment in China in the future.

摘要

直接作用抗病毒药物（DAAs）是海外治疗丙型肝炎病毒（HCV）的主要手段。但DAAs耐药性越来越受到临床医生的关注。尽管部分DAAs正在进行临床试验，但截至目前在中国尚未获批。然而，深入了解DAAs耐药性对于优化HCV治疗方案、提高持续病毒学应答（SVR）率以及减少临床治疗失败至关重要。本文综述了DAAs的耐药机制及耐药的病毒学屏障、预先存在的DAAs耐药相关变异（RAVs）的流行情况、RAVs对治疗结局的影响、耐药后治疗方案的选择以及耐药检测，希望能为未来中国DAAs的规范化治疗提供一些帮助。