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Gut:治疗丙肝新方法

  1. 丙肝
  2. 丙肝病毒
  3. 新方法
  4. 治疗

来源:生物谷 2016-04-21 17:32

一项初步研究发现所有急性丙肝患者经过六周的短期直接抗病毒疗法治疗在随后的12周后检测不到丙肝病毒。研究者发起的研究证明sofosbuvir和ledipasvir两种药物在六周时间内就足以治疗急性丙肝病毒患者。

2016年4月21日讯/生物谷BIOON/--一项初步研究发现所有急性丙肝患者经过六周的短期直接抗病毒疗法治疗在随后的12周后检测不到丙肝病毒。研究者发起的研究证明sofosbuvir和ledipasvir两种药物在六周时间内就足以治疗急性丙肝病毒患者。

丙肝病毒感染者通常发展成急性丙型肝炎, 感染者通过自身可以清除10%到50%的病毒。丙肝病毒感染的早期诊断比较罕见,该病通常可能被忽视直到病人已经出现了一些严重的肝损伤。 Sofosbuvir 和ledipasvir是一个可能治疗慢性丙肝患者的方案。在12周的治疗过程中持续病毒学应答(SVR)超过95%。

“鉴于治疗期间sofosbuvir和ledipasvir药物的高成本和相关副作用的原因, 对于急性丙型肝炎患者来说我们着手评估是否缩短治疗时间可能是一个有效的选择。”德国汉诺威医学院Katja Deterding说,“我们的研究表明,sofosbuvir和ledipasvir的联合治疗很安全, 患有严重肝脏疾病,而且肝酶很高的急性丙肝基因1型病人都有良好的耐受性和有效性,而且更短期的治疗时间似乎并不妨碍药物功效。”Heiner Wedemeyer教授说。

德国的初步研究对20名患者进行了调查。研究成员调查丙肝病毒感染患者的危险因素包括:性传播(n = 11),医疗过程/针刺损伤(n = 5),药物使用(n = 1),指甲治疗并发症(n = 1)。剩下的两个病人原因不明。

所有的20名患者服用了6周的sofosbuvir和ledipasvir没有利巴韦林的药物。通过12周的随访研究发现,20名患者都检测不到丙肝病毒,而且SVR达到100%。研究成员称疲劳是最常见的副作用 (30%)。

“这些令人兴奋的具有成本效益的治疗方法可以预防丙肝病毒在高危人群中的传播。”Frank Tacke教授说。“我们期待看到这项初步研究的结果可以通过验证,然后希望该结果使临床效果变得更好。”(生物谷Bioon.com)

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Treating viral hepatitis C: efficacy, side effects, and complications

M P Manns, H Wedemeyer, and M Cornberg

Early identification of patients with acute HCV infection is important for their optimal management. The rate of chronic evolution is 50–90%, and the natural course of chronic hepatitis C can be associated with severe complications. Patients with chronic hepatitis C have the potential risk of developing liver cirrhosis and hepatocellular carcinoma.1 The social burden of HCV infection is high, including for health care workers. Extrahepatic manifestations of HCV are often troublesome and may not be reversible with viral eradication.2 These are good reasons for the design of a prophylactic vaccine but as this has yet to be accomplished, early treatment of acute HCV infection with interferon alpha (IFN) is the only option to prevent chronicity. Immediate treatment of patients with symptomatic acute hepatitis C with recombinant IFN or pegylated IFN (PEG‐IFN) monotherapy for 24 weeks can prevent the development of chronic hepatitis C in approximately 90% of cases.3,4,5 Combination with ribavirin is not necessary.6 However, symptomatic patients also have a good chance to clear HCV spontaneously.7,8 This usually occurs in the first 12 weeks after the onset of symptoms. A wait and see strategy (that is, treatment of only those patients who remain HCV‐RNA positive 12 weeks after the onset of symptoms) resulted in an overall sustained virological response (self limited and treatment induced) in 91% of patients.8 A study coordinated by the German competence network for viral hepatitis (Hep‐Net)9 is underway to test if a wait and see strategy may be as effective as immediate treatment (www.kompetenznetz‐hepatitis.de/study_house/hcv_III_studie.htm). Asymptomatic patients however should be treated immediately as they have a higher risk for chronic evolution. Post exposure prophylaxis (for example, short duration IFN administration after a needlestick injury to prevent HCV infection) is not necessary.10 The future may bring highly effective antiviral drugs which allow short term treatment for all acutely infected patients..

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