Department of Hepatology, Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France; Hepatinov, Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France; Université Paris-Sud, Université Paris-Saclay, Villejuif, France; INSERM, Unité 1193, Villejuif, France.
Department of Hepatology, Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France; Hepatinov, Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France; Université Paris-Sud, Université Paris-Saclay, Villejuif, France; INSERM, Unité 1193, Villejuif, France.
Lancet Gastroenterol Hepatol. 2016 Oct;1(2):165-172. doi: 10.1016/S2468-1253(16)30008-5. Epub 2016 Sep 8.
The approval of direct-acting antiviral agents that may be given orally in an interferon-free regimen has greatly changed the landscape of treatment for hepatitis C virus (HCV) infection, especially for patients with the most severe disease, who have decompensated cirrhosis, or who are waiting for or have undergone liver transplantation. Treatment with interferon proved to be ineffective and poorly tolerated because of high risks of infection and transplant rejection. The availability of new drugs poses new questions about the optimum time to give treatment to prevent HCV recurrence, taking into account efficacy, tolerance, and drug-drug interactions. Treatment is acceptable before and after transplantation, but the two strategies have subtle differences. In this Review, we present the available data on the treatment of HCV infection before and after transplantation, and discuss new challenges for practice.
直接作用抗病毒药物的获批，使得无需干扰素的口服治疗方案得以实现，这极大地改变了丙型肝炎病毒 (HCV) 感染的治疗格局，尤其是对于那些患有最严重疾病（失代偿性肝硬化）、正在等待或已经接受过肝移植的患者。由于感染和移植排斥的风险较高，干扰素治疗被证明无效且耐受性差。新型药物的出现带来了新的问题，即考虑疗效、耐受性和药物相互作用，何时给予治疗以预防 HCV 复发最佳。治疗在移植前后均可接受，但两种策略存在细微差异。在这篇综述中，我们介绍了移植前后 HCV 感染治疗的现有数据，并讨论了实践中的新挑战。
