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直接作用抗病毒药物治疗肿瘤患者丙型肝炎的安全性:临床经验与文献综述

Safety of direct acting antiviral treatment for hepatitis C in oncologic setting: A clinical experience and a literature review.

作者信息

Spera Anna Maria

机构信息

Infectious Disease Unit, Universitary Hospital OO RR San Giovanni di Dio e Ruggi d'Aragona, Salerno 84131, Italy.

出版信息

World J Hepatol. 2022 Mar 27;14(3):525-534. doi: 10.4254/wjh.v14.i3.525.

DOI:10.4254/wjh.v14.i3.525
PMID:35582286
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9055195/
Abstract

With a globally estimated 58 million people affected by, chronic hepatitis C virus (HCV) infection still represents a hard challenge for scientific community. A chronic course can occur among patients with a weak innate ad adaptive response with cirrhosis and malignancies as main consequences. Oncologic patients undergoing chemotherapy represent a special immunocompromised population predisposed to HCV reactivation (HCVr) with undesirable changes in cancer treatment and outcome. Aim of the study highlight the possibility of HCVr in oncologic population eligible to chemotherapy and its threatening consequences on cancer treatment; underline the importance of HCV screening before oncologic therapy and the utility of direct aging antivirals (DAAs). A comprehensive overview of scientific literature has been made. Terms searched in PubMed were: "HCV reactivation in oncologic setting" "HCV screening", "second generation DAAs". Pharmacokinetic and Pharmacodynamics characteristics of DAAs are reported, along with drug - drug interactions among chemotherapeutic drug classes regimens and DAAs. Clinical trials conducted among oncologic adults with HCV infection eligible to both chemotherapy and DAAs were analyzed. Viral eradication with DAAs in oncologic patients affected by HCV infection is safe and helps liver recovery, allowing the initiation of cancer treatment no compromising its course and success.

摘要

全球估计有5800万人受到慢性丙型肝炎病毒(HCV)感染的影响,这对科学界来说仍然是一项艰巨的挑战。在先天和适应性反应较弱的患者中可能会出现慢性病程,主要后果是肝硬化和恶性肿瘤。接受化疗的肿瘤患者是一类特殊的免疫功能低下人群,易发生HCV再激活(HCVr),从而对癌症治疗和预后产生不良影响。本研究的目的是强调符合化疗条件的肿瘤人群中HCVr的可能性及其对癌症治疗的威胁性后果;强调肿瘤治疗前HCV筛查的重要性以及直接抗病毒药物(DAAs)的效用。我们对科学文献进行了全面综述。在PubMed中搜索的术语有:“肿瘤环境中的HCV再激活”“HCV筛查”“第二代DAAs”。报告了DAAs的药代动力学和药效学特征,以及化疗药物类别方案与DAAs之间的药物相互作用。分析了在符合化疗和DAAs治疗条件的HCV感染肿瘤成人患者中进行的临床试验。在受HCV感染的肿瘤患者中,使用DAAs根除病毒是安全的,有助于肝脏恢复,能够在不影响癌症治疗进程和成功率的情况下开始癌症治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58bf/9055195/19fc9b5e1d47/WJH-14-525-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58bf/9055195/19fc9b5e1d47/WJH-14-525-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58bf/9055195/19fc9b5e1d47/WJH-14-525-g001.jpg

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本文引用的文献

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World J Gastroenterol. 2021 Aug 21;27(31):5181-5188. doi: 10.3748/wjg.v27.i31.5181.
2
Drug-Drug Interactions of Newly Approved Direct-Acting Antiviral Agents in Patients with Hepatitis C.丙型肝炎患者中新获批的直接作用抗病毒药物的药物相互作用
Int J Gen Med. 2021 Jan 28;14:289-301. doi: 10.2147/IJGM.S283910. eCollection 2021.
3
Reconsidering the management of patients with cancer with viral hepatitis in the era of immunotherapy.
在免疫治疗时代重新考虑患有病毒性肝炎的癌症患者的管理。
J Immunother Cancer. 2020 Oct;8(2). doi: 10.1136/jitc-2020-000943.
4
Oncologic Implications of Chronic Hepatitis C Virus Infection.慢性丙型肝炎病毒感染的肿瘤学意义。
J Oncol Pract. 2019 Dec;15(12):629-637. doi: 10.1200/JOP.19.00370.
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A brief history of the treatment of viral hepatitis C.丙型病毒性肝炎治疗简史
Clin Liver Dis (Hoboken). 2012 Mar 6;1(1):6-11. doi: 10.1002/cld.1. eCollection 2012 Feb.
6
Viral Hepatitis C Therapy: Pharmacokinetic and Pharmacodynamic Considerations: A 2019 Update.丙型肝炎病毒治疗:药代动力学和药效学考虑因素:2019 年更新。
Clin Pharmacokinet. 2019 Oct;58(10):1237-1263. doi: 10.1007/s40262-019-00774-0.
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Hepatitis C Virus Infection in Patients With Cancer: Impact on Clinical Trial Enrollment, Selection of Therapy, and Prognosis.癌症患者的丙型肝炎病毒感染:对临床试验入组、治疗选择及预后的影响
Gastroenterology. 2019 Oct;157(4):909-916. doi: 10.1053/j.gastro.2019.01.271. Epub 2019 Feb 21.
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