直接抗病毒药物抗HCV治疗进展

摘要

聚乙二醇干扰素α联合利巴韦林是慢性丙型肝炎的标准抗病毒方案,但其疗效有限,且不良反应明显.直接抗病毒药物(direct-acting antiviral agents,DAAs)的出现为慢性丙型肝炎的治疗提供了更多选择.DAAs包括NS3/4A蛋白酶抑制剂、NS5B多聚酶抑制剂及NS5A抑制剂等.目前已有多种药物完成了临床前研究,部分完成了Ⅲ期临床试验.结果 显示使用DAAs可明显提高持续病毒学应答获得率.但DAAs的临床使用经验有限,一些问题如对药物的耐受性、联合使用及耐药等仍须进一步研究.%Pegylated Interferon combined with ribavirin is considered as standard treatment of chronic hepatitis C. However, it provides limited efficacy and is associated with frequent adverse reactions. Direct-acting antiviral agents (DAAs), which include NS3/ 4A protease inhibitors, NS5B polymera.se inhibitors and NS5A inhibitors, have heralded a new era in the treatment of chronic hepatitis C. So far, preclinical studies of some DAAs have already been completed and some phase Ⅲ clinical trails have been completed as well. These studies have shown that DAAs can significantly improve sustained virological response. However, clinical experience with DAAs is limited, and some problems about drug tolerance, combination therapy and drug resistance should be further studied.