a Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences , Hiroshima University , Hiroshima , Japan.
b Liver Research Project Center , Hiroshima University , Hiroshima , Japan.
Expert Rev Clin Pharmacol. 2017 Jun;10(6):583-594. doi: 10.1080/17512433.2017.1313111. Epub 2017 Apr 10.
Because of the rapid pace of development of new direct-acting antiviral (DAA) drugs, chronic hepatitis C virus (HCV) infection is now increasingly considered curable. However, the emphasis on DAA therapies disregards key issues related to cost, availability, and antiviral resistance. Areas covered: This perspective provides an overview of current HCV therapies and the development of DAAs, followed by a discussion of the limitations of DAA therapy. A literature search was used to select relevant studies, and a web search for relevant news articles and press releases was conducted. Expert commentary: Despite cure rates exceeding 90%, now is not the time to declare victory against HCV but to reinforce recent progress by addressing the issues of cost and availability as well as by developing strategies to manage antiviral resistance. Future drug development efforts should place greater emphasis on targeting host factors required for HCV replication, for which the barrier to resistance is higher, and effort should continue to develop a vaccine against HCV. Finally, efforts should be made to facilitate large-scale screening in endemic areas to identify and treat patients as early as possible to reduce long-term risks of advanced liver disease and their attendant costs of management.
由于新的直接作用抗病毒 (DAA) 药物的快速发展，慢性丙型肝炎病毒 (HCV) 感染现在被认为越来越可以治愈。然而，对 DAA 治疗的重视忽略了与成本、可及性和抗病毒耐药性相关的关键问题。
本观点概述了目前的 HCV 治疗方法和 DAA 的发展，随后讨论了 DAA 治疗的局限性。通过文献检索选择了相关研究，并对相关新闻文章和新闻稿进行了网络搜索。
尽管治愈率超过 90%，但现在还不是宣布战胜 HCV 的时候，而是要通过解决成本和可及性问题，以及制定管理抗病毒耐药性的策略，来加强最近的进展。未来的药物开发工作应更加重视针对 HCV 复制所需的宿主因素，因为这些因素的耐药性更高，应继续努力开发 HCV 疫苗。最后，应努力在流行地区进行大规模筛查，以尽早发现和治疗患者，从而降低晚期肝病的长期风险及其管理成本。
