Forde Kimberly A, Bhattacharya Debika
Curr Treat Options Infect Dis. 2017 Jun;9(2):262-276. doi: 10.1007/s40506-017-0124-x. Epub 2017 May 25.
The landscape of therapeutic options for HCV infection has dramatically changed with the approval of all-oral direct-acting antiviral (DAA) regimens. DAAs target important steps in the HCV viral life cycle, resulting in higher response rates and fewer adverse events than were afforded with interferon and ribavirin, the prior standard of care. The achievement of sustained virologic response (SVR) rates in excess of 90% with use of DAA regimens has not only translated into HCV eradication for the hundreds of thousands treated but is also anticipated to decrease the incidence of major complications associated with chronic HCV infection. Additionally, the favorable side effect profile of DAAs has made HCV therapy feasible in difficult-to-treat populations, including those with previous exposure to interferon and ribavirin, cirrhosis, decompensated liver disease, HIV and HCV co-infection, and severe renal dysfunction/end stage renal disease. Given this tremendous progress, all patients infected with HCV infection should be treated.
随着全口服直接抗病毒（DAA）方案的获批，丙型肝炎病毒（HCV）感染的治疗选择格局发生了巨大变化。DAA靶向HCV病毒生命周期中的重要步骤，与之前的标准治疗药物干扰素和利巴韦林相比，其应答率更高，不良事件更少。使用DAA方案实现超过90%的持续病毒学应答（SVR）率，不仅使数十万接受治疗的患者得以清除HCV，而且预计还会降低与慢性HCV感染相关的主要并发症的发生率。此外，DAA良好的副作用特征使HCV治疗在难以治疗的人群中切实可行，这些人群包括既往接触过干扰素和利巴韦林的患者、肝硬化患者、失代偿性肝病患者、HIV与HCV合并感染患者以及严重肾功能不全/终末期肾病患者。鉴于这一巨大进展，所有感染HCV的患者均应接受治疗。
