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成人丙型肝炎病毒基因型4、5和6慢性感染的治疗方案

Author
Andrew J Muir, MD, MHS
Section Editor
Adrian M Di Bisceglie, MD
Deputy Editor
Allyson Bloom, MD
Translators
郭传勇, 主任医师，教授

引言

目前，在全世界已发现了6种主要的丙型肝炎病毒(hepatitis C virus, HCV)基因型。HCV所有的基因型都既可导致急性肝炎又可导致慢性肝炎。急性肝炎病程呈自限性，极少引起肝衰竭，但通常会导致慢性感染。慢性HCV感染常呈持续多年的进行性病程，最终可导致肝硬化、肝细胞癌，并且需要肝移植。 (参见“慢性丙型肝炎病毒感染的临床表现和自然病程”)

治疗的目的是根除HCV RNA，可通过获得持续病毒学应答(sustained virologic response, SVR)来预测，SVR的定义为停止治疗后3-6个月时聚合酶链反应检测不到HCV RNA。获得SVR的患者在长期随访期间HCV RNA阴性的可能性为99%，因此可认为HCV感染治愈[1]。获得SVR也可使临床结局得到改善。 (参见“慢性丙型肝炎病毒感染的处理概述”和“抗病毒治疗慢性丙型肝炎病毒感染的患者评估和选择”，关于‘治疗原理’一节)

HCV的药物研发主要针对基因型1、2和3，这3种基因型是欧洲和北美最常见的基因型。随着广泛覆盖所有基因型的直接作用抗病毒药物的问世，感染基因型4、5和6的患者也有新的治疗选择。

本专题将总结HCV基因型4、5和6慢性感染者的抗病毒治疗。慢性HCV感染的一般处理、抗病毒治疗患者的评估与选择、其他基因型患者的抗病毒治疗、HCV治疗的试验性药物和急性HCV感染的治疗将在别处讨论：

●(参见“慢性丙型肝炎病毒感染的处理概述”)

                   

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Literature review current through: 2017-06 . | This topic last updated: 2017-06-14.
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