Bourlière Marc, Pietri Olivia, Castellani Paul, Oules Valérie, Adhoute Xavier
Hepato-Gastroenterology Department, Hospital Saint Joseph, 26 Bd de Louvain 13008 Marseilles, France.
Hepato-Gastroenterology Department, Hospital Saint Joseph, Marseilles, France.
Therap Adv Gastroenterol. 2018 Dec 2;11:1756284818812358. doi: 10.1177/1756284818812358. eCollection 2018.
The advent of oral direct-acting antiviral agents (DAAs) has dramatically improved the hepatitis C virus (HCV) treatment landscape in the last 4 years, providing cure rates over 95% with a shorter duration of treatment and a very good safety profile. This has enabled access to treatment in nearly all HCV infected patients. The launch of two pangenotypic fixed dose combinations (FDCs) in 2017 made a new step forward in HCV treatment by slightly increasing efficacy and more importantly allowing the treatment of patients without HCV genotyping, and in some cases without fibrosis assessment. However, retreatment of the few DAA failure patients was still an issue for some HCV genotypes. The launch of the triple regimen FDC, sofosbuvir/velpatasvir/voxilaprevir, solves this issue by providing a cure rate over 96% regardless of HCV genotype. In this review, we describe the current HCV treatment landscape and focus on the development of this triple FDC either in treatment-naïve or treatment-experienced patients with previous failure on a DAA regimen.
在过去4年中，口服直接抗病毒药物（DAA）的出现极大地改善了丙型肝炎病毒（HCV）的治疗局面，治疗治愈率超过95%，治疗时间更短，安全性也非常好。这使得几乎所有HCV感染患者都能获得治疗。2017年两种泛基因型固定剂量复方制剂（FDC）的推出在HCV治疗方面又向前迈进了一步，疗效略有提高，更重要的是，无需对患者进行HCV基因分型，在某些情况下甚至无需进行纤维化评估就能进行治疗。然而，对于少数DAA治疗失败的患者，再次治疗仍是某些HCV基因型面临的一个问题。三联疗法FDC索磷布韦/维帕他韦/伏西瑞韦的推出解决了这一问题，无论HCV基因型如何，治愈率均超过96%。在本综述中，我们描述了当前HCV的治疗局面，并重点介绍了这种三联FDC在初治或曾接受DAA方案治疗但失败的经治患者中的应用进展。
