Clinical Application of Direct-acting Antivirals in Hepatitis C Patients

doi:10.12114/j.issn.1007-9572.2020.00.337

Abstract

Abstract: Hepatitis C virus （HCV） infection is common in patients with chronic renal insufficiency.In those with dialysis，the risk of HCV infection is even higher.Besides，the risks of HCV-related hepatocellular carcinoma and cirrhosis are also significantly increased.In recent years，direct-acting antivirals have achieved good efficacy and safety in the treatment of chronic hepatitis C.This paper aims to summarize the application progress of DAAs in patients with hepatitis C on dialysis，conludes that G/P regimen is recommended for patients with HCV on dialysis of genotype 1-6 and SOF is not recommended for patients with hepatitis C on dialysis because of the high blood concentration of SOF in people with severe renal impairment due to renal metabolism.

Key words: Hepatitis C, Hepatitis C virus, Direct-acting antivirals, Dialysis, Review

摘要： 丙型肝炎病毒（HCV）感染在慢性肾功能不全患者中较常见，尤其是在进行透析的患者中，HCV感染较普通患者的风险极大增加，同时还会导致肝细胞癌及肝硬化的发病率明显升高。近年来直接抗病毒药物（DAAs）在慢性丙型肝炎的治疗中取得了较好的疗效及安全性，本文通过总结DAAs在丙型肝炎合并透析患者中的应用进展，发现对于基因1~6型HCV合并透析患者，推荐使用G/P方案；由于索磷布韦（SOF）经肾脏代谢，在重度肾损害人群中的血药浓度较高，因此SOF组合方案并不推荐用于丙型肝炎合并透析患者的治疗。

关键词: 丙型肝炎, 丙型肝炎病毒, 直接抗病毒药物, 透析, 综述

LIANG Wenyan,MA Aixia. Clinical Application of Direct-acting Antivirals in Hepatitis C Patients　[J]. Chinese General Practice, 2020, 23(29): 3661-3666. DOI: 10.12114/j.issn.1007-9572.2020.00.337.
梁文焰,马爱霞. 直接抗病毒药物治疗丙型肝炎合并透析患者的临床应用[J]. 中国全科医学, 2020, 23(29): 3661-3666. DOI: 10.12114/j.issn.1007-9572.2020.00.337.

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