Zhao Y F, Xu L, Mi Y Q
Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin 300070, China.
Department of Hepatology, Tianjin Second People's Hospital, Tianjin 300192, China.
Zhonghua Gan Zang Bing Za Zhi. 2024 Jan 20;32(1):87-90. doi: 10.3760/cma.j.cn501113-20231126-00237.
Chronic hepatitis C is a kind of viral hepatitis caused by hepatitis C virus infection, which can further progress to cirrhosis, liver failure, hepatocellular carcinoma, and even death. Presently, there is no preventive vaccine yet. Therefore, preventing infection and safe and effective drug treatment are currently the most effective strategies for dealing with hepatitis C virus infection. Since 2014, the clinical application of direct-acting antiviral drugs has brought revolutionary changes to the treatment of chronic hepatitis C. Direct-acting antiviral drugs have an excellent hepatitis C virus clearance effect, are well tolerated, have a good safety profile, and can significantly improve liver function, metabolic disorders, immune dysfunction, etc. However, some studies have pointed out that even if the hepatitis C virus is cleared during the treatment of chronic hepatitis C-related cirrhosis with direct-acting antiviral drugs, a considerable proportion of patients still have severe liver failure, hepatocellular carcinoma, and even liver disease-related death, so there are still some problems in the treatment of chronic hepatitis C- related cirrhosis with direct-acting antiviral drugs that need to be further explored. This article reviews the research progress of direct-acting antiviral drugs so as to provide meaningful references for the treatment of patients with chronic hepatitis C-related cirrhosis.
慢性丙型肝炎是一种由丙型肝炎病毒感染引起的病毒性肝炎，可进一步发展为肝硬化、肝衰竭、肝细胞癌，甚至死亡。目前尚无预防性疫苗。因此，预防感染以及安全有效的药物治疗是当前应对丙型肝炎病毒感染最有效的策略。自2014年以来，直接抗病毒药物的临床应用给慢性丙型肝炎的治疗带来了革命性变化。直接抗病毒药物具有出色的丙型肝炎病毒清除效果，耐受性良好，安全性高，能显著改善肝功能、代谢紊乱、免疫功能障碍等。然而，一些研究指出，即使在使用直接抗病毒药物治疗慢性丙型肝炎相关肝硬化期间丙型肝炎病毒被清除，仍有相当比例的患者会出现严重肝衰竭、肝细胞癌，甚至肝病相关死亡，所以直接抗病毒药物治疗慢性丙型肝炎相关肝硬化仍存在一些问题有待进一步探索。本文综述直接抗病毒药物的研究进展，以期为慢性丙型肝炎相关肝硬化患者的治疗提供有意义的参考。
