慢性丙型肝炎抗病毒治疗效果影响因素的研究进展

曲思麦; 张琳

慢性丙型肝炎抗病毒治疗效果影响因素的研究进展

曲思麦,
张琳

中国医科大学附属盛京医院感染科

详细信息

中图分类号: R512.63
计量
- 文章访问数: 3926
- HTML全文浏览量: 15
- PDF下载量: 759
- 被引次数: 0
出版历程
- 出版日期: 2011-12-20

Research advancement of antiviral treatment for chronic hepatitis C

Qu SiMai,
Zhang Lin

摘要

摘要: 聚乙二醇干扰素联合利巴韦林是目前慢性丙型肝炎抗病毒治疗的标准治疗方案,约70%的患者能够获得持续的病毒学应答,病毒和宿主因素对治疗的结局有决定性影响。部分患者对治疗无应答或治疗后复发,称为难治性丙型肝炎。对干扰素治疗结果的预测一直是研究的热点。近年有研究报道,利用患者的基线特征以及对治疗的不同病毒学应答模式,可以对远期的治疗结果进行预测,能更好的帮助临床医生设计治疗方案。新型抗病毒药物的问世,也将为难治性丙型肝炎的治疗提供新的方案。
- 肝炎病毒属 /
- 肝炎,丙型,慢性 /
- 基因型 /
- 病毒载量 /
- 肥胖症
Abstract: Pegylated interferon plus ribavirin is the standard treatment for chronic hepatitis C currently.About 70% patients can achieve sustained virological response, viral and host factors have a decisive impact on the outcome of the treatment.Patients who did not response to the treatment or relapse after treatment were defined as refractory hepatitis C.Prediction of interferon therapy has been the research focus.In recent years, studies have reported that taking advantage of baseline characteristics of patients and virologic response to treatment in different models can predict long-term treatment outcomes.It can help clinicians design a better treatment plan.Forthcoming new antiviral drugs also provide the new program for the treatment of refractory hepatitis C.
- hepacivirus /
- hepatitis C /
- chronic /
- genotype /
- viral load

HTML全文

参考文献(37)

[1]亚太区肝病研究协会丙型肝炎协助组.亚太区肝病年会丙型肝炎诊治专家共识[J].中华实验和临床感染病杂志, 2007, 1 (1) :88-94.

[2]Gordon SC.Treatment of viral hepatitis-2001[J].Ann Med, 2001, 33 (6) :385-390.

[3]Fried MW, Shiffman ML, Reddy KR, et al.Peginterferon al-pha-2a plus ribavirin for chronic hepatitis C virus infection[J].N Engl J Med, 2002, 347 (13) :975-982.

[4]Hadziyannis SJ, Sette HJ, Morgan TR, et al.Peginterferon alpha-2a and ribavirin combination therapy in chronic hepati-tis C:a randomized study of treatment duration and ribavirin dose[J].Ann Intern Med, 2004, 140 (5) :346-355.

[5]Zeuzem S, Pawlotsky JM, Lukasiewicz E, et al.Internation-al, multicenter, randomized, controlled study comparing dy-namically individualized versus standard treatment in patients with chronic hepatitis C[J].J Hepatol, 2005, 43 (2) :250-257.

[6]Ghany MG, Strader DB, Thomas DL, et al.Diagnosis, manage-ment, and treatment of hepatitis C:an update[J].Hepatology, 2009, 49 (4) :1335-1374.

[7]Pawlotsky JM.Treating hepatitis C in“difficult-to-treat”patients[J].N Engl J Med, 2004, 351:422-423.

[8]Fried MW, Jensen DM, Rodriguez-Torres M, et al.Improved outcomes in patients with hepatitis C with difficult-to-treat characteristics:randomized study of higher doses of pegjnter-feron alpha-2a and ribavirin[J].Hepatology, 2008, 48 (4) :1033-1043.

[9]Alberti A.What are the comorbidities influencing the man-agement of patients and the response to therapy in chronic hepatitis C?[J].Liver Int, 2009, 29 (Suppl1) :15-18.

[10]庄辉, Tracy L, 崔怡辉, 等.我国部分地区丙型肝炎病毒基因分型研究[J].中华流行病学杂志, 2001, 22 (2) :99-101.

[11]Shifman ML, Suter F, Bacon BR, et al.Peginterferon alfa-2a and fibavirin for16or24weeks in HCV genotype2or3[J].N Engl J Med, 2007, 357 (2) :124-134.

[12]Yu JW, Wang GQ, Sun LJ, et al.Predictive value of rapid virological response and early virological response on sus-tained virological response in HCV patients treated with pegy-lated interferon alpha-2a and ribavirin[J].J Gastroenterol Hepatol, 2007, 22 (6) :832-836.

[13]Dalgard O, Mangia A.Short-term therapy for patients with hepatitis C virus genotype2or3infection[J].Drugs, 2006, 66 (14) :1807-1815.

[14]Jensen DM, Morgan TR, Marcellin P, et al.Early identifica-tion of HCV genotype l patients responding to24weeks peginterferon alpha-2a (40kd) /ribavirin therapy[J].Hepa-tology, 2006, 43 (5) :954-960.

[15]Marcellin P, Heathcote EJ, Craxi A.Which patients with geno-type l chronic hepatitis C can benefit from prolonged treatment with the‘accordion’regimen?[J].J Hepatol, 2007, 47 (4) :580-587.

[16]Orito E, Mizokami M, Suzuki K, et al.Loss of serum HCV RNA at week4of interferon-alpha therapy is associated with more favorable long-term response in patients with chronic hepatitis C[J].J Med Virol, 1995, 46 (2) :109-115.

[17]Bressler BL, Guindi M, Tomlinson G, et al.High body massindex is an independent risk factor for nonresponse to antivi-ral treatment in chronic hepatitis C[J].Hepatology, 2003, 38 (3) :639-644.

[18]Jacobson IM, Brown RS Jr, McCone J, et al.Impact of weight-based ribavirin with peginteferon alfa-2b in African Americans with hepatitis C virus genotype1[J].Hepatolo-gy, 2007, 46 (4) :982-990.

[19]Castera L.Steatosis, insulin resistance and fibrosis progres-sion in chronic hepatitis C[J].Minerva Gastroenterol Dietol, 2006, 52 (2) :125-134.

[20]Soresi M, Tripi S, Franco V, et al.Impact of liver steatosis on the antiviral response in the hepatitis C virus-associated chronic hepatitis[J].Liver Int, 2006, 26 (9) :1119-1125.

[21]Cortez-Pinto H.Concluding remarks:metabolic syndrome, liver and HCV[J].Aliment Pharmacol Ther, 2005, 22 (Suppl 2) :83-85.

[22]Westin J, Lagging M, Dhillon AP, et al.Impact of hepatic steatosis on viral kinetics and treatment outcome during anti-viral treatment of chronic HCV infection[J].J Viral Hepat, 2007, 14 (1) :29-35.

[23]D’Souza R, Sabin CA, Foster GR.Insulin resistance plays a significant role in liver fibrosis in chronic hepatitis C and in the response to antiviral therapy[J].Am J Gastronenterol, 2005, 100 (7) :1509-1515.

[24]Conjeevaram HS, Kleiner DE, Everhart JE, et al.Race, in-sulin resistance and hepatic steatosis in chronic hepatitis C[J].Hepatology, 2007, 45 (1) :80-87.

[25]Romero-Gomez M, Del Mar Viioria M, Andrade RJ, et al.Insulin resistance impairs sustained response rate to peginterferon plus ribavirin in chronic hepatitis C patients[J].Gastroenterology, 2005, 128 (3) :636-641.

[26]Bueverov AO, Griazin AE, IvashkinVT, et al.Apoptosis of peripheral blood mononuclears and evaluation of the effec-tiveness of antiviral therapy of chronic C hepatitis[J].Klin Med (Mosk) , 2006, 84 (9) :39-44.

[27]Katayama K, Kasahara A, Sasaki Y, et al.Immunological re-sponse to interferon-gamma priming prior to interferon-al-pha treatment in refractory chronic hepatitis C in relation to viral clearance[J].J Viral Hepat, 2001, 8 (3) :180-185.

[28]Ishii K, Takamura N, Shinohara E, et al.Intracellular cytokineanalysis of CD4-positive T cells predictive of sustained re-sponse to interferon therapy for patients with chronic hepati-tis C[J].Dig Dis Sci, 2002, 47 (4) :778-783.

[29]Mihm U, Herrmann E, Sarrazin U, et al.Association of ser-um interleukin-8with virologic response to antiviral therapy in patients with chronic hepatitis C[J].J Hepatol, 2004, 40 (5) :845-852.

[30]何智敏, 赵艳, 张永宏, 等, 丙型肝炎患者基线T细胞分化状态与快速病毒学应答的相关性分析[J].首都医科大学学报, 2009, 30 (6) :775-779.

[31]Ge D, Fellay J, Thompson AJ, et al.Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance[J].Na-ture, 2009, 461 (7262) :399-401.

[32]Thomas DL, Thio CL, Martin MP, et al.Genetic variation in lL28B and spontaneous clearance of hepatitis C virus[J].Nature, 2009, 461 (7265) :798-801.

[33]Suppiah V, Moldovan M, Ahlenstiel G, et al.IL28B is asso-ciated with response to chronic hepatitis C interferon—alpha and ribavirin therapy[J].Nat Genet, 2009, 41:1100-1104.

[34]McHutchison JG, Lawitz EJ, Shiffman ML, et al.Peginter-feron alfa-2b or alfa-2a with ribavirin for treatment of hepa-titis C infection[J].N Engl J Med, 2009, 361 (10) :580-593.

[35]Liu CH, Liu CJ, Lin CL, et al.Pegylated interferon-alpha-2a plus ribavirin for treatment-naive Asian patients with hep-atitis C virus genotype1infection:a multicenter, randomized controlled trial[J].Clin Infect Dis, 2008, 47 (10) :1260-1269.

[36]Rauch A, Kutalik Z, Descombes P, et al.Genetic variation in IL28B is associated with chronic hepatitis C and treatment failure a genome-wide association study[J].Gastroenter-ology, 2010, 138 (4) :1338-1345.

[37]Tanaka Y, Nishida N, Sugiyama M, et al.Genome-wide association of IL-28B with response to pegylated interferon-alpha and ribavirin therapy for chronic hepatitis C[J].Nat Genet, 2009, 41 (10) :1105F-1109F.

施引文献

资源附件(0)

访问统计