正文丙型病毒性肝炎治疗进展
在APSAL大会第四天,MichaelP.Manns教授做了题为AdvancesinHepatitisCInfection的大会报告。他提出丙型病毒性肝炎已经可以根据基因型及早期治疗反应行个体化治疗。
MichaelP.MannsMedicalSchoolofHannover,GermanyOnthefourthdayofAPASL,ProfessorMichaelP.MannspresentedalectureonadvancesinhepatitisCinfection.Hesaidinrecentyears,therapyforhepatitisChadbeenoptimizedbyindividualizingoftreatmentaccordingtogenotypeandearlytreatmentresponse.
Achievingrapidvirologicalrespons(RVR)canshorternthedurationoftreatment.Forallgenotype1patientsearlyvirologicalresponse(EVR)hasbecomeveryimportanttoguidetreatment.IftheydonotachieveEVR,treatmentisstoppedsincesuccessratesareminimal.
Thefinalgoaloftreatmentistoachievesustainedvirologicalresponse(SVR).IthasbeenshownthatrelapseratesinpatientsachievingSVRareextremelyrare.
Healsomentionedsmalldirectantiviralmolecules,inparticularHCVproteaseandpolymeraseinhibitorswereunderclinicaldevelopment.Thesenewdrugsincombinationwithstandardofcarewillreducethedurationoftreatmentingenotype1patientsaswellasimprovetheoverallcurerates.Forinstance,theproteaseinhibitors,TelaprevirandBoceprevirareverypromisingtoreducedurationoftreatmentfrom48to24weeksandimproveSVRratesto55to65%inthesepatients.
HopefullytheyalsowillhelpcureHCVinnon-respondersorrelapserstopreviousstandardofcare.Telaprevirincombinationwithstandardofcaremade41%ofnon-respndersand75%ofrelapsersachieveSVR.
在APSAL大会第四天,MichaelP.Manns教授做了题为“AdvancesinHepatitisCInfection”的大会报告。他提出丙型病毒性肝炎已经可以根据基因型及早期治疗反应行个体化治疗。达到快速病毒学应答可相应缩短疗程;而对于基因型1型患者若无法达到早期病毒学应答,则治愈率低可停止治疗。治疗的最终目标是达到持续病毒学应答。此外MichaelP.Manns教授还提到新型药物HCV蛋白酶抑制剂、聚合酶抑制剂正处在临床试验中,它们与标准治疗联合应用有望缩短疗程,同时提高SVR率,对于标准治疗无应答或复发患者亦可能有效。
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