慢性丙型肝炎抗病毒治疗个体化疗程选择_West China Medical Journal

Authors：

郭丽琳 ,  雷学忠

Corresponding author：

雷学忠, Email: djgw123@163.com

Keywords：

慢性丙型肝炎; 干扰素; 利巴韦林; 基因型; 病毒学应答; 疗程

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丙型肝炎病毒感染后大多数患者转为慢性感染，若不及时正确地进行治疗，相当比例患者会产生严重临床后果，丙型肝炎患者一旦确诊应积极行抗病毒治疗。根据病毒基因型及患者治疗过程中病毒学应答情况来预测疗效并相应调整治疗方案，成为目前抗病毒治疗的研究热点。

Citation： 郭丽琳,雷学忠. 慢性丙型肝炎抗病毒治疗个体化疗程选择. West China Medical Journal, 2012, 27(9): 1431-1433. doi: Copy

1.	Firpi RJ, Clark V, Soldevila-Pico C, et al. The natural history of hepatitis C cirrhosis after liver transplantation[J]. Liver Transpl, 2009, 15(9): 1063-1071.
2.	慢性丙型肝炎抗病毒治疗专家委员会. 慢性丙型肝炎抗病毒治疗专家共识[J]. 中华实验和临床感染病杂志·电子版, 2009, 3(3): 343-352.
3.	Sánchez-Tapias JM, Diago M, Escartín P, et al. Peginterferon-alfa2a plus ribavirin for 48 versus 72 weeks in patients with detectable hepatitis C virus RNA at week 4 of treatment[J]. Gastroenterology, 2006, 131(2): 451-460.
4.	Ghany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: an update[J]. Hepatology, 2009, 49(4): 1352-1374.
5.	Yu ML, Dai CY, Huang JF, et al. Rapid virological response and treatment duration for chronic hepatitis C genotype 1b infected chronic hepatitis C patients:a randomised trial[J]. Hepatology, 2008, 47(6): 1884-1893.
6.	Liu CH, Liu CJ, Lin CL, et al. Pegylated interferon-alpha-2a plus ribavirin for treatment-naive Asian patients with hepatitis C virus genotype 1 infection: a multicenter, randomized controlled trial[J]. Clin Infect Dis, 2008, 47(10): 1260-1269.
7.	Berg T, Weich V, Teuber G, et al. Individualized treatment strategy according to early viral kinetics in hepatitis C virus type 1-infected patients[J]. Hepatology, 2009, 50(2): 369-377.
8.	Moreno C, Deltenre P, Pawlotsky JM, et al. Shortened treatment duration in treatment-naive genotype 1 HCV patients with rapid virological response: a meta-analysis[J]. J Hepatol, 2010, 52(1): 25-31.
9.	Berg T, von Wagner M, Nasser S, et al. Extended treatment duration for hepatitis C virus type 1: comparing 48 versus 72 weeks of peginterferon-alfa-2a plus ribavirin[J]. Gastroenterology, 2006, 130(4): 1086-1097.
10.	Pearlman BL, Ehleben C, Saifee S. Treatment extension to 72 weeks of peginterferon and ribavirin in hepatitis c genotype 1-infected slow responders[J]. Hepatology, 2007, 46(6): 1688-1694.
11.	Farnik H, Lange CM, Sarrazin C, et al. Meta-analysis shows extended therapy improves response of patients with chronic hepatitis C virus genotype 1 infection[J]. Clin Gastroenterol Hepatol, 2010, 8(10): 884-890.
12.	成军. 慢性丙型肝炎治疗的新进展[J]. 中华实验和临床感染病杂志: 电子版, 2010, 4(1): 1-5.
13.	Ide T, Hino T, Ogata K, et al. A randomized study of extended treatment with peginterferon alpha-2b plus ribavirin based on time to HCV RNA negative-status in patients with genotype 1b chronic hepatitis C[J]. Am J Gastroenterol, 2009, 104(1): 70-75.
14.	Chayama K, Hayes CN, Yoshioka K, et al. Factors predictive of sustained virological response following 72 weeks of combination therapy for genotype 1b hepatitis C[J]. J Gastroenterol, 2011, 46(4): 545-555.
15.	Mangia A, Minerva N, Bacca D, et al. Individualized treatment duration for hepatitis C genotype 1 patients: A randomized controlled trial[J]. Hepatology, 2008, 47(1): 43-50.
16.	European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatitis C virus infection[J]. Hepatology, 2011 ,55(2): 245-264.
17.	Shiffman ML, Suter F, Bacon BR, et al. Peginterferon alfa-2a and ribavirin for 16 or 24 weeks in HCV genotype 2 or 3[J]. N Engl J Med, 2007, 357(2): 124-134.
18.	Dalgard O, Bjøro K, Ring-Larsen H, et al. A randomized controlled trial of pegylated interferon alfa and ribavirin for 14 vs 24 weeks in patients with HCV genotype 2 or 3 and rapid virological response[J]. Hepatology, 2008, 47(1): 35-42.
19.	Yu ML, Dai CY, Huang JF, et al. A randomised study of peginterferon and ribavirin for 16 versus 24 weeks in patients with genotype 2 chronic hepatitis C[J]. Gut, 2007, 56(4): 553-559.
20.	Kau A, Vermehren J, Sarrazin C. Treatment predictors of a sustained virologic response in hepatitis B and C[J]. J Hepatol, 2008, 49(4): 634-651.
21.	Romero-Gómez M, Fernández-Rodríguez CM, Andrade RJ, et al. Effect of sustained virological response to treatment on the incidence of abnormal glucose values in chronic hepatitis C[J]. J Hepatol, 2008, 48(5): 721-727.
22.	Mangia A, Minerva N, Bacca D, et al. Determinants of relapse after a short (12 weeks) course of antiviral therapy and re-treatment efficacy of a prolonged course in patients with chronic hepatitis C virus genotype 2 or 3 infection[J]. Hepatology, 2009, 49(2): 358-363.
23.	Lagging M, Langeland N, Pedersen C, et al. Randomized comparison of 12 or 24 weeks of peginterferon alpha 2a and ribavirin in chronic hepatitis C virus genotype 2/3 infection[J]. Hepatology, 2008, 47(6): 1837-1845.
24.	Willems B, Hadziyannis SJ, Morgan TR, et al. Should treatment with peginterferon plus ribavirin be intensified in patients with HCV genotype 2/3without a rapid virologic response[J]. Hepatol, 2007, 46(Suppl 1): S6.
25.	Shiffman ML, Minola E, Barange K, et al. Characterisation of HCV genotype 2/3 patients without a rapid virological response (RVR) optimising treatment by predicting slower responders to peginterferon a2a plus ribavirin[J]. Hepatol, 2007, 46(Suppl 1): S245.
26.	Lam KD, Trinh HN, Do ST, et al. Randomized controlled trial of pegylated interferon-alfa 2a and ribavirin in treatment-naive chronic hepatitis C genotype 6[J]. Hepatology, 2010, 52(5): 1573-1580.
27.	Zhou YQ, Wang XH, Hong GH, et al. Twenty-four weeks of pegylated interferon plus ribavirin effectively treat patients with HCV genotype 6a[J]. J Viral Hepat, 2011, 18(8): 595-600.

1. 　Firpi RJ, Clark V, Soldevila-Pico C, et al. The natural history of hepatitis C cirrhosis after liver transplantation[J]. Liver Transpl, 2009, 15(9): 1063-1071.
2. 　慢性丙型肝炎抗病毒治疗专家委员会. 慢性丙型肝炎抗病毒治疗专家共识[J]. 中华实验和临床感染病杂志·电子版, 2009, 3(3): 343-352.
3. 　Sánchez-Tapias JM, Diago M, Escartín P, et al. Peginterferon-alfa2a plus ribavirin for 48 versus 72 weeks in patients with detectable hepatitis C virus RNA at week 4 of treatment[J]. Gastroenterology, 2006, 131(2): 451-460.
4. 　Ghany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: an update[J]. Hepatology, 2009, 49(4): 1352-1374.
5. 　Yu ML, Dai CY, Huang JF, et al. Rapid virological response and treatment duration for chronic hepatitis C genotype 1b infected chronic hepatitis C patients:a randomised trial[J]. Hepatology, 2008, 47(6): 1884-1893.
6. 　Liu CH, Liu CJ, Lin CL, et al. Pegylated interferon-alpha-2a plus ribavirin for treatment-naive Asian patients with hepatitis C virus genotype 1 infection: a multicenter, randomized controlled trial[J]. Clin Infect Dis, 2008, 47(10): 1260-1269.
7. 　Berg T, Weich V, Teuber G, et al. Individualized treatment strategy according to early viral kinetics in hepatitis C virus type 1-infected patients[J]. Hepatology, 2009, 50(2): 369-377.
8. 　Moreno C, Deltenre P, Pawlotsky JM, et al. Shortened treatment duration in treatment-naive genotype 1 HCV patients with rapid virological response: a meta-analysis[J]. J Hepatol, 2010, 52(1): 25-31.
9. 　Berg T, von Wagner M, Nasser S, et al. Extended treatment duration for hepatitis C virus type 1: comparing 48 versus 72 weeks of peginterferon-alfa-2a plus ribavirin[J]. Gastroenterology, 2006, 130(4): 1086-1097.
10. 　Pearlman BL, Ehleben C, Saifee S. Treatment extension to 72 weeks of peginterferon and ribavirin in hepatitis c genotype 1-infected slow responders[J]. Hepatology, 2007, 46(6): 1688-1694.
11. 　Farnik H, Lange CM, Sarrazin C, et al. Meta-analysis shows extended therapy improves response of patients with chronic hepatitis C virus genotype 1 infection[J]. Clin Gastroenterol Hepatol, 2010, 8(10): 884-890.
12. 　成军. 慢性丙型肝炎治疗的新进展[J]. 中华实验和临床感染病杂志: 电子版, 2010, 4(1): 1-5.
13. 　Ide T, Hino T, Ogata K, et al. A randomized study of extended treatment with peginterferon alpha-2b plus ribavirin based on time to HCV RNA negative-status in patients with genotype 1b chronic hepatitis C[J]. Am J Gastroenterol, 2009, 104(1): 70-75.
14. 　Chayama K, Hayes CN, Yoshioka K, et al. Factors predictive of sustained virological response following 72 weeks of combination therapy for genotype 1b hepatitis C[J]. J Gastroenterol, 2011, 46(4): 545-555.
15. 　Mangia A, Minerva N, Bacca D, et al. Individualized treatment duration for hepatitis C genotype 1 patients: A randomized controlled trial[J]. Hepatology, 2008, 47(1): 43-50.
16. 　European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatitis C virus infection[J]. Hepatology, 2011 ,55(2): 245-264.
17. 　Shiffman ML, Suter F, Bacon BR, et al. Peginterferon alfa-2a and ribavirin for 16 or 24 weeks in HCV genotype 2 or 3[J]. N Engl J Med, 2007, 357(2): 124-134.
18. 　Dalgard O, Bjøro K, Ring-Larsen H, et al. A randomized controlled trial of pegylated interferon alfa and ribavirin for 14 vs 24 weeks in patients with HCV genotype 2 or 3 and rapid virological response[J]. Hepatology, 2008, 47(1): 35-42.
19. 　Yu ML, Dai CY, Huang JF, et al. A randomised study of peginterferon and ribavirin for 16 versus 24 weeks in patients with genotype 2 chronic hepatitis C[J]. Gut, 2007, 56(4): 553-559.
20. 　Kau A, Vermehren J, Sarrazin C. Treatment predictors of a sustained virologic response in hepatitis B and C[J]. J Hepatol, 2008, 49(4): 634-651.
21. 　Romero-Gómez M, Fernández-Rodríguez CM, Andrade RJ, et al. Effect of sustained virological response to treatment on the incidence of abnormal glucose values in chronic hepatitis C[J]. J Hepatol, 2008, 48(5): 721-727.
22. 　Mangia A, Minerva N, Bacca D, et al. Determinants of relapse after a short (12 weeks) course of antiviral therapy and re-treatment efficacy of a prolonged course in patients with chronic hepatitis C virus genotype 2 or 3 infection[J]. Hepatology, 2009, 49(2): 358-363.
23. 　Lagging M, Langeland N, Pedersen C, et al. Randomized comparison of 12 or 24 weeks of peginterferon alpha 2a and ribavirin in chronic hepatitis C virus genotype 2/3 infection[J]. Hepatology, 2008, 47(6): 1837-1845.
24. 　Willems B, Hadziyannis SJ, Morgan TR, et al. Should treatment with peginterferon plus ribavirin be intensified in patients with HCV genotype 2/3without a rapid virologic response[J]. Hepatol, 2007, 46(Suppl 1): S6.
25. 　Shiffman ML, Minola E, Barange K, et al. Characterisation of HCV genotype 2/3 patients without a rapid virological response (RVR) optimising treatment by predicting slower responders to peginterferon a2a plus ribavirin[J]. Hepatol, 2007, 46(Suppl 1): S245.
26. 　Lam KD, Trinh HN, Do ST, et al. Randomized controlled trial of pegylated interferon-alfa 2a and ribavirin in treatment-naive chronic hepatitis C genotype 6[J]. Hepatology, 2010, 52(5): 1573-1580.
27. 　Zhou YQ, Wang XH, Hong GH, et al. Twenty-four weeks of pegylated interferon plus ribavirin effectively treat patients with HCV genotype 6a[J]. J Viral Hepat, 2011, 18(8): 595-600.

West China Medical Journal

慢性丙型肝炎抗病毒治疗个体化疗程选择

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