Division of Digestive Diseases, Mount Sinai Beth Israel Medical Center, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 2G, New York, NY 10003, USA.
Division of Digestive Diseases, Mount Sinai Beth Israel Medical Center, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 2G, New York, NY 10003, USA.
Clin Liver Dis. 2017 Nov;21(4):659-672. doi: 10.1016/j.cld.2017.06.007. Epub 2017 Aug 19.
Treatment of hepatitis C virus has been vastly transformed by the arrival of all-oral, interferon-free, direct-acting antiviral regimens. Despite the high rate of success with these agents, a small portion of treated patients fail therapy and the emergence of viral resistance is the most common cause of treatment failure. Given the error-prone hepatitis C virus polymerase, baseline resistance-associated substitutions (RASs) may be present before direct-acting antiviral exposure. Clinicians need to understand the role of baseline RAS testing and the settings and manner in which the treatment regimens need to be customized based on the presence of RASs.
通过使用全口服、无干扰素、直接作用抗病毒药物方案，丙型肝炎病毒的治疗已经发生了巨大变化。尽管这些药物的成功率很高，但仍有一小部分接受治疗的患者治疗失败，病毒耐药性的出现是治疗失败最常见的原因。鉴于丙型肝炎病毒聚合酶易出错，在直接作用抗病毒药物暴露之前，可能存在基线耐药相关替代（RAS）。临床医生需要了解基线 RAS 检测的作用，以及根据 RAS 的存在，需要在何种情况下对治疗方案进行何种方式的定制。
