Boston University School of Medicine, Boston, MA, USA.
Hamad Medical Corporation, Doha, Qatar.
Curr HIV/AIDS Rep. 2019 Oct;16(5):389-394. doi: 10.1007/s11904-019-00466-1.
Direct acting antiviral agents (DAAs) have emerged as simple, short, safe, and effective treatments for chronic hepatitis C (CHC) infection. CHC is a systemic disease with frequent and multiple extrahepatic manifestations. The beneficial effects of DAA treatment regimens extend beyond improvement in liver-related outcomes to amelioration of extra hepatic manifestations and are likely to have economic implications. The purpose of this review is to evaluate the effect of DAAs on extra hepatic manifestations of CHC virus infection.
Recent studies indicate that DAAs are associated with reduction in all-cause mortality, even in patients without significant hepatic fibrosis. They are also associated with reduction in incident cardiovascular disease and diabetes. DAAs are the mainstay of treatment in HCV-associated cryoglobulinemia and lymphoma. Successful HCV therapy with DAAs also improves patient-related outcomes such as health-related quality of life. DAAs improve extrahepatic manifestations of CHC virus infection. Future studies are needed to evaluate the long-term durability of treatment response and for accounting amelioration of extrahepatic manifestations into the cost effectiveness of DAA regimens.
直接作用抗病毒药物（DAAs）已成为治疗慢性丙型肝炎（CHC）感染的简便、短期、安全且有效的方法。CHC 是一种全身性疾病，常伴有多种肝外表现。DAA 治疗方案的有益效果不仅可改善肝脏相关结局，还可改善肝外表现，且可能具有经济效益。本文旨在评估 DAA 对 CHC 病毒感染肝外表现的影响。
最近的研究表明，DAA 可降低全因死亡率，甚至在无明显肝纤维化的患者中也是如此。它们还可降低心血管疾病和糖尿病的发生率。DAA 是 HCV 相关冷球蛋白血症和淋巴瘤的主要治疗方法。成功的 DAA 治疗 HCV 还可改善患者相关结局，如健康相关生活质量。DAA 可改善 CHC 病毒感染的肝外表现。未来需要研究来评估治疗反应的长期持久性，并将肝外表现的改善纳入 DAA 方案的成本效益分析中。
