Gamal Nesrine, Gitto Stefano, Andreone Pietro
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
J Clin Transl Hepatol. 2016 Dec 28;4(4):336-344. doi: 10.14218/JCTH.2016.00038. Epub 2016 Nov 3.
Hepatitis C virus (HCV) infection is a growing public health concern, with 184 million people infected worldwide. During the past decade, interferon has been the backbone of HCV treatment, even though it remains far from ideal. The latest development of the new direct antivirals has drastically changed the treatment approach for chronic hepatitis C (CHC). Inhibitors of the HCV NS5A region have garnered remarkable interest among treating physicians, due to their high potency and favourable safety profile. In particular, treatment with daclatasvir (DCV) has yielded high rates of vriologic response in patients infected with genotype (Gt) 1 and Gt 3, when used in combination with other antivirals of a different class, such as sofosbuvir. Although few data are available for DCV treatment of the other Gts, the results in patients with Gt 2 and Gt 4 infection appear promising, as do those for unique patient populations. NS5A-resistant viral variants can pre-exist or emerge after treatment failure for the HCV NS5A inhibitors. Nonetheless, DCV-resistant viral variants continue to be sensitive to interferon and other classes of antivirals such as NS3/4A and NS5B inhibitors. Herein, we aimed to provide an overview of the current knowledge about DCV in the treatment of CHC.
丙型肝炎病毒（HCV）感染是一个日益严重的公共卫生问题，全球有1.84亿人感染。在过去十年中，干扰素一直是HCV治疗的主要药物，尽管它仍远非理想。新型直接抗病毒药物的最新发展极大地改变了慢性丙型肝炎（CHC）的治疗方法。HCV NS5A区域的抑制剂因其高效力和良好的安全性，在治疗医生中引起了极大的兴趣。特别是，当与其他不同类别的抗病毒药物（如索磷布韦）联合使用时，使用达卡他韦（DCV）治疗基因型（Gt）1和Gt 3感染的患者产生了高病毒学应答率。虽然关于DCV治疗其他Gt的数据很少，但Gt 2和Gt 4感染患者的结果以及独特患者群体的结果似乎很有希望。NS5A耐药病毒变体可以在HCV NS5A抑制剂治疗失败之前就存在或出现。尽管如此，DCV耐药病毒变体仍然对干扰素和其他类别的抗病毒药物（如NS3/4A和NS5B抑制剂）敏感。在此，我们旨在概述目前关于DCV治疗CHC的知识。
