Saeed Naba, Gurakar Ahmet
Department of Transplant Hepatology, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Transplant Hepatology, Johns Hopkins University School of Medicine, Division of Gastroenterology and Hepatology, Baltimore Maryland, USA.
Euroasian J Hepatogastroenterol. 2016 Jan-Jun;6(1):35-42. doi: 10.5005/jp-journals-10018-1163. Epub 2016 Jul 9.
Hepatitis C virus (HCV) is known to cause chronic hepatitis C, and its sequelae of cirrhosis and hepatocellular carcinoma. Hepatitis C genotype 3 (HCV-3) in particular is notorious for causing accelerated liver fibrosis, cardiovascular, and metabolic effects, thus increasing morbidity and mortality. It is the commonest variant in Asian countries like India and Pakistan. It is also one of the hardest-to-treat genotypes, especially among treatment-experienced and cirrhotic patients. Due to limited health care affordability and accessibility in these areas, many patients remain untreated. Until recently, the established therapy for HCV had been a combination of pegylated interferon + ribavirin. However, it was only effective in about half of patients and had severe adverse effects; hence a more efficacious option needed to be found. Recent advances have led to the development of sofosbuvir, an NS5B inhibitor that is fast becoming the standard of care, in combination with other novel drugs. It was initially marketed at $1,000 per pill, a cost that was too high for most. Thus, it has not been utilized as a global therapy as yet. Formulation of effective interferon-free regimens is a huge milestone, and awareness needs to be raised regarding these new highly effective options in both the physician and the patient population. This article discusses the newest drugs and combinations that have been developed in the fight against HCV-3, as a treatment outline for HCV-3-dominant areas. It also highlights recent breakthroughs in cost reductions of these drugs and the effort to make them globally accessible.
Saeed N, Gurakar A. Tackling HCV-3 in Asia: Breakthroughs for Efficient and Cost-effective Treatment Strategies. Euroasian J Hepato-Gastroenterol 2016;6(1):35-42.
已知丙型肝炎病毒（HCV）可导致慢性丙型肝炎及其肝硬化和肝细胞癌后遗症。特别是丙型肝炎基因3型（HCV-3），因其导致肝纤维化加速、心血管和代谢影响而声名狼藉，从而增加发病率和死亡率。它是印度和巴基斯坦等亚洲国家最常见的变异型。它也是最难治疗的基因型之一，尤其是在有治疗经验的患者和肝硬化患者中。由于这些地区医疗保健的可承受性和可及性有限，许多患者仍未得到治疗。直到最近，已确立的HCV治疗方法一直是聚乙二醇化干扰素+利巴韦林联合使用。然而，它仅对约一半的患者有效，且有严重的不良反应；因此需要找到一种更有效的选择。最近的进展导致了索磷布韦的开发，这是一种NS5B抑制剂，正迅速成为治疗的标准药物，并与其他新药联合使用。它最初的售价为每片1000美元，这一成本对大多数人来说过高。因此，它尚未被用作全球治疗药物。有效的无干扰素治疗方案的制定是一个巨大的里程碑，需要提高医生和患者群体对这些新的高效治疗方案的认识。本文讨论了在对抗HCV-3方面开发的最新药物和联合用药，作为HCV-3占主导地区的治疗概述。它还强调了这些药物在成本降低方面的最新突破以及使其在全球范围内可及的努力。
Saeed N, Gurakar A. Tackling HCV-3 in Asia: Breakthroughs for Efficient and Cost-effective Treatment Strategies. Euroasian J Hepato-Gastroenterol 2016;6(1):35-42.
