management of treatment-naive chronic hcv patients：天真的治疗慢性丙型肝炎患者的管理

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1、AntiviraltreatmentofchronichepatitisCinIVDUsettingsPetrUrbánekDepartmentofInternalMedicine,1stMedicalFacultyCharlesUniversityandCentralMilitaryHospitalPraguepetr.urbanek@uvn.czGoalsofHepatitisCTreatmentPrimaryEradicatethevirusSecondaryPreventprogressiontocirrhosisReduceincid

2、enceofHCCReduceneedfortransplantationEnhancesurvivalDavisGL,etal.JHepatol.1995;22(suppl1):110-114.LindsayKL.Hepatology.1997;26(suppl1):71S-77S.ManagementofHepatitisC:NIHConsensusConferenceStatementAllpatientswithchronichepatitisCarepotentialcandidatesforantiviraltherapyHCV

3、therapyhasbeensuccessfulevenwhenthepatientshavenotabstainedfromcontinueddrugoralcoholuse....Thus,itisrecommendedthattreatmentofactiveinjectiondrugusebeconsideredonacase-by-casebasisandthatactiveinjectiondruguseinandofitselfnotbeusedtoexcludesuchpatientsfromantiviraltherapy.T

4、reatmentisrecommendedforpatientswithanincreasedriskofdevelopingcirrhosisNIHManagementofHepatitisCConsensusConferenceStatement.June10-12,2002.CurrentlyApprovedTreatmentsforHCVTherapyChronicillnessmanagedwithcombinationofInterferonalfa(subcutaneousinjections)Interferonalfa2aa

5、lfa2bconsensusinterferonalfa-1Pegylatedinterferonalfa2aalfa2bRibavirin(tablets)Directlyactingantivirals(tablets)TelaprevirBoceprevirNIHRecommendedHCVTherapiesPeg-IFN+RBVmoreeffectivethanstandardIFN+RBVcombinationorpeg-IFNaloneGenotype1Peg-IFN+RBV1000-1200mg/day→48weeksGeno

6、type2or3Peg-IFN+RBV800mg/day→24weeksGoaloftreatmentisSVRDefinedasNodetectableserumHCVRNA24weeksaftertheendoftreatmentTestedusingsensitiveHCVRNAassaywithlowerlimitofdetectionof50IU/mLNIHManagementofHepatitisCConsensusConferenceStatement.June10-12,2002.NIHConsensusStatementRe

7、commendsTreatingIDUsManagementofHCVisenhancedbylinkingtodrug-treatmentprogramsMethadoneisnotacontraindicationtoHCVtreatmentHCVtreatmentofactiveIDUsshouldbeconsideredonacase-by-casebasisActiveIDUinandofitselfshouldnotexcludesuchpatientsfromantiviraltherapyNIHManagementofHepat

8、itisCConsensusConferenceStatement.June10-12,2002..EvaluationofIDUsforViralH