Predictive factors associated with hepatitis C antiviral therapy response  

作　　者：Lourianne Nascimento Cavalcante André Castro Lyra 

机构地区：[1]Hospital Sao Rafael-Gastro-Hepatology Service [2]Department of Medicine, Federal University of Bahia

出　　处：《World Journal of Hepatology》2015年第12期1617-1631,共15页世界肝病学杂志（英文版）（电子版）

摘　　要：Hepatitis C virus(HCV) infection may lead to significant liver injury, and viral, environmental, host, immunologic and genetic factors may contribute to the differences in the disease expression and treatment response. In the early 2000 s, dual therapy using a combinationof pegylated interferon plus ribavirin(PR) became the standard of care for HCV treatment. In this PR era, predictive factors of therapy response related to virus and host have been identified. In 2010/2011, therapeutic regimens for HCV genotype 1 patients were modified, and the addition of NS3/4a protease inhibitors(boceprevir or telaprevir) to dual therapy increased the effectiveness and chances of sustained virologic response(SVR). Nevertheless, the first-generation triple therapy is associated with many adverse events, some of which are serious and associated with death, particularly in cirrhotic patients. This led to the need to identify viral and host predictive factors that might influence the SVR rate to triple therapy and avoid unnecessary exposure to these drugs. Over the past four years, hepatitis C treatment has been rapidly changing with the development of new therapies and other developments. Currently, with the more recent generations of pangenotipic antiviral therapies, there have been higher sustained virologic rates, and prognostic factors may not have the same importance and strength as before. Nonetheless, some variables may still be consistent with the low rates of non-response with regimens that include sofosbuvir, daclatasvir and ledipasvir. In this manuscript, we review the predictive factors of therapy response across the different treatment regimens over the last decade including the new antiviral drugs.Hepatitis C virus （HCV） infection may lead to significantliver injury, and viral, environmental, host, immunologicand genetic factors may contribute to the differencesin the disease expression and treatment response.In the early 2000s, dual therapy using a combination of pegylated interferon plus ribavirin （PR） becamethe standard of care for HCV treatment. In this PRera, predictive factors of therapy response related tovirus and host have been identified. In 2010/2011,therapeutic regimens for HCV genotype 1 patients weremodified, and the addition of NS3/4a protease inhibitors（boceprevir or telaprevir） to dual therapy increasedthe effectiveness and chances of sustained virologicresponse （SVR）. Nevertheless, the first-generation tripletherapy is associated with many adverse events, some ofwhich are serious and associated with death, particularlyin cirrhotic patients. This led to the need to identifyviral and host predictive factors that might influencethe SVR rate to triple therapy and avoid unnecessaryexposure to these drugs. Over the past four years,hepatitis C treatment has been rapidly changing with thedevelopment of new therapies and other developments.Currently, with the more recent generations of pangenotipicantiviral therapies, there have been highersustained virologic rates, and prognostic factors maynot have the same importance and strength as before.Nonetheless, some variables may still be consistent withthe low rates of non-response with regimens that includesofosbuvir, daclatasvir and ledipasvir. In this manuscript,we review the predictive factors of therapy responseacross the different treatment regimens over the lastdecade including the new antiviral drugs.

关 键 词：Hepatitis C Direct ACTING ANTIVIRALS Antiviraltherapy INTERFERON SUSTAINED VIROLOGIC response 

分 类 号：R512.63[医药卫生—内科学]