型肝炎的治疗:系统性审查
Anita Kohli1, Ashton Shaffer2, Amy Sherman2
1Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research Inc, Frederick National Laboratory for Cancer Research, Frederick, Maryland2Critical Care Medicine Department, Clinical Research Center, National Institutes of.
JAMA
|August 14, 2014
概括
新的型肝炎病毒 (HCV) 疗法提供高持续病毒学反应 (SVR) 率. 这些更简单,更短的治疗方法可能会增加治疗慢性HCV感染的患者数量.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 型肝炎病毒 (HCV) 影响全球超过1.85亿人,其中20%的病例进展为肝硬化.
- 目前的治疗模式正在发展,超越基于干扰素的治疗方案.
- 直接作用的抗病毒药物为HCV根除提供了更简单,更有针对性的方法.
研究的目的:
- 审查基于干扰素和无干扰素的治疗方案对HCV的安全性,有效性和耐受性.
- 为HCV和HIV-HCV共感染提供基于证据的治疗建议.
- 根据HCV基因型和肝硬化状态来评估治疗结果.
主要方法:
- 从2009年1月到2014年5月进行了全面的文献搜索.
- 包括2期,3期和4期研究,评估19063名成年患者的HCV治疗.
- 证据强度和建议使用牛津证据医学中心的标准进行分级.
主要成果:
- 在美国流行的HCV基因型1显示高SVR率 (89%-90%) 索福斯布维尔 + 基化干扰素 + 里巴维林.
- 基因型1的替代疗法包括西梅普雷维尔 + 化干扰素 + 里巴维林 (SVR 79%-86%).
- 基因型2和3单独使用索福斯布维尔+瑞巴维林实现了高SVR (基因型2: 82%-93%;基因型3: 80%-95%).
- 艾滋病毒-HCV共感染患者和补偿性肝硬化患者接受了类似的治疗方案.
结论:
- 新型,短期和简化疗法在HCV患者中实现了高持续性病毒学反应率.
- 增加HCV查和新的治疗选择预计将扩大治疗机会.
- 这些进展表明,可能会向更广泛的消除慢性HCV感染转变.
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