坚持治疗C型肝炎病毒:我们所知道的
Steven L Flamm1, Alessandra Mangia2
1Division of Digestive Diseases and Nutrition, Rush University Medical School, Chicago, Illinois.
Seminars in liver disease
|April 24, 2024
概括
针对型肝炎病毒 (HCV) 的直接作用抗病毒疗法即使错过了剂量也有效. 患者,包括注射药物使用者 (PWID),可以达到很高的治愈率,因此不应因为坚持问题而拒绝治疗.
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:
- 直接作用的抗病毒药物 (DAA) 为C型肝炎病毒 (HCV) 提供高治愈率.
- 担心不坚持,特别是在像注射毒品 (PWID) 的人群中,往往导致拒绝DAA治疗.
- 跨不同患者群体的DAA坚持和疗效之间的关系还没有得到很好的定义.
研究的目的:
- 评估在不同患者群体中对DAA治疗的坚持和治疗疗效之间的关系.
- 讨论标准化HCV治疗的依从性评估方法所面临的挑战.
- 为了探索DAA在特殊人群中的有效性,如PWID,尽管坚持变化.
主要方法:
- 对不同HCV患者群体的DAA坚持和持续病毒学反应 (SVR) 现有数据的审查.
- 分析传统和基于技术的方法来评估药物坚持.
- 讨论特定的DAA疗法 (例如,索福斯布维尔/韦尔帕塔斯维尔,格莱卡普雷维尔/皮布伦塔斯维尔) 以及他们对遗漏剂量的宽恕.
主要成果:
- 在各种患者群体中,DAA疗法表现出高效率和遗漏剂量的宽恕.
- 特殊人群,包括PWID,可以通过DAA治疗实现持续病毒学反应 (SVR) 的高率.
- 传统的依从性评估方法可能会高估依从性,而基于技术的方法提供了更高的准确性.
结论:
- 由于害怕不坚持,不应该停止对HCV的抗病毒治疗.
- 在HCV患者,包括PWID患者中,高SVR率是可以实现的,即使附着度低于最佳.
- 改进的坚持评估和干预策略可以进一步提高HCV治疗中的SVR率.
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