Burstow Nicholas J, Mohamed Zameer, Gomaa Asmaa I, Sonderup Mark W, Cook Nicola A, Waked Imam, Spearman C Wendy, Taylor-Robinson Simon D
Liver Unit, Department of Surgery and Cancer, Imperial College London, London, UK.
National Liver Institute, Menoufiya University, Shbeen El Kom, Egypt.
Int J Gen Med. 2017 Feb 17;10:39-52. doi: 10.2147/IJGM.S127689. eCollection 2017.
Chronic hepatitis C infection affects millions of people worldwide and confers significant morbidity and mortality. Effective treatment is needed to prevent disease progression and associated complications. Previous treatment options were limited to interferon and ribavirin (RBV) regimens, which gave low cure rates and were associated with unpleasant side effects. The era of direct-acting antiviral (DAA) therapies began with the development of first-generation NS3/4A protease inhibitors in 2011. They vastly improved outcomes for patients, particularly those with genotype 1 infection, the most prevalent genotype globally. Since then, a multitude of DAAs have been licensed for use, and outcomes for patients have improved further, with fewer side effects and cure rates approaching 100%. Recent regimens are interferon-free, and in many cases, RBV-free, and involve a combination of DAA agents. This review summarizes the treatment options currently available and discusses potential barriers that may delay the global eradication of hepatitis C.
慢性丙型肝炎感染影响着全球数百万人，并导致严重的发病率和死亡率。需要有效的治疗方法来预防疾病进展及相关并发症。以前的治疗选择仅限于干扰素和利巴韦林（RBV）方案，治愈率低且伴有令人不适的副作用。直接抗病毒（DAA）疗法时代始于2011年第一代NS3/4A蛋白酶抑制剂的研发。它们极大地改善了患者的治疗效果，尤其是对于基因型1感染患者，这是全球最常见的基因型。从那时起，多种DAA药物已获许可使用，患者的治疗效果进一步改善，副作用减少，治愈率接近100%。最近的治疗方案不含干扰素，在许多情况下也不含RBV，并且涉及DAA药物的联合使用。本综述总结了目前可用的治疗选择，并讨论了可能延迟全球丙型肝炎根除的潜在障碍。
