Lampejo Temi
Infection Sciences, King's College Hospital, London, United Kingdom.
J Clin Exp Hepatol. 2022 Jul-Aug;12(4):1225-1237. doi: 10.1016/j.jceh.2022.02.003. Epub 2022 Feb 22.
Chronic hepatitis E virus (HEV) infection, which occurs almost exclusively in immunocompromised patients, if untreated may progress to cirrhosis and possibly hepatocellular carcinoma. The reduction of immunosuppression and/or administration of ribavirin is frequently curative but there remain many immunocompromised individuals whose HEV infection is refractory to these therapeutic strategies. Moreover, the haematological toxicity of ribavirin limits its use. Pegylated interferon has demonstrated success in a small number of patients with chronic HEV infection; however, the potentially increased risk of graft rejection associated with its use renders it unsuitable for many transplant recipients. Alternative therapeutic strategies are therefore required. This article reviews the and literature to date of the antiviral agent sofosbuvir (well established in the treatment of hepatitis C) in the treatment of HEV infection.
慢性戊型肝炎病毒(HEV)感染几乎仅发生于免疫功能低下的患者,若不治疗可能进展为肝硬化,并有可能发展为肝细胞癌。减少免疫抑制和/或使用利巴韦林通常可治愈疾病,但仍有许多免疫功能低下的个体,其HEV感染对这些治疗策略无效。此外,利巴韦林的血液学毒性限制了其使用。聚乙二醇干扰素已在少数慢性HEV感染患者中显示出疗效;然而,其使用可能增加移植排斥反应的风险,使其不适用于许多移植受者。因此,需要其他治疗策略。本文综述了抗病毒药物索磷布韦(在丙型肝炎治疗中已得到充分确立)治疗HEV感染的现有文献。