对直接作用抗病毒失败的丙型肝炎病毒感染患者的再治疗

StephenW

Semin Liver Dis. 2019 Apr 30. doi: 10.1055/s-0039-1687823. [Epub ahead of print]
Retreatment of Hepatitis C Virus-Infected Patients with Direct-Acting Antiviral Failures.
Pawlotsky JM1,2.
Author information

1
    Department of Virology, National Reference Center for Viral Hepatitis B, C and D, Université Paris-Est, Hôpital Henri Mondor, Créteil, France.
2
    Research team "Viruses, Hepatology, Cancers", INSERM U955, Créteil, France.

Abstract

The treatment of chronic hepatitis C virus (HCV) infection has considerably evolved with the development of safe and well-tolerated combinations of direct-acting antiviral (DAA) drugs yielding high rates of infection cure. However, some patients fail to achieve a sustained virological response while receiving the most recent DAA combinations. Several waves of treatment failures have occurred concomitantly to the use of different drug combinations. The outcome of their retreatment strongly depends on the DAA(s) received and the retreatment regimen(s) available. This article discusses virological failure rates with the successive waves of HCV combination regimens, the reasons for failure, the role of HCV resistance, and current retreatment options. The triple combination of sofosbuvir, velpatasvir, and voxilaprevir for 12 weeks is the first-line retreatment strategy in patients previously exposed to DAAs. Difficult-to-retreat patients may benefit from the combination of sofosbuvir plus glecaprevir/pibrentasvir and/or the addition of ribavirin and/or longer retreatment duration.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

PMID:
    31041789
DOI:
    10.1055/s-0039-1687823

StephenW

Semin Liver Dis。 2019年4月30日doi：10.1055 / s-0039-1687823。 [印刷前的电子版]
对直接作用抗病毒失败的丙型肝炎病毒感染患者的再治疗。
Pawlotsky JM1,2。
作者信息

1
    病毒学系，病毒性乙型肝炎，C和D国家参考中心，UniversitéParis-Est，HôpitalHenriMondor，Créteil，France。
2
    研究团队“病毒，肝脏病学，癌症”，INSERM U955，法国Créteil。

抽象

随着直接作用抗病毒（DAA）药物的安全且耐受良好的组合的发展，慢性丙型肝炎病毒（HCV）感染的治疗已经相当大地发展，从而产生高感染率。然而，一些患者在接受最新的DAA组合时未能获得持续的病毒学应答。使用不同的药物组合同时发生了几波治疗失败。他们的再治疗结果很大程度上取决于所接受的DAA和可用的再治疗方案。本文讨论了HCV组合方案连续波动的病毒学失败率，失败的原因，HCV抗药性的作用以及目前的再治疗方案。 sofosbuvir，velpatasvir和voxilaprevir三联组合12周是先前接受DAA治疗的患者的一线再治疗策略。难以退缩的患者可以从sofosbuvir加glecaprevir / pibrentasvir和/或加入利巴韦林和/或更长的再治疗持续时间的组合中受益。

Thieme Medical Publishers 333 Seventh Avenue，New York，NY 10001，USA。

结论：
    31041789
DOI：
    10.1055 / S-0039-1687823