丙型病毒性肝炎治疗进展

Michael P. Manns
Medical School of Hannover, Germany

On the fourth day of APASL, Professor Michael P. Manns presented a lecture on advances in hepatitis C infection. He said in recent years, therapy for hepatitis C had been optimized by individualizing of treatment according to genotype and early treatment response. Achieving rapid virological respons (RVR) can shortern the duration of treatment. For all genotype 1 patients early virological response (EVR) has become very important to guide treatment. If they do not achieve EVR, treatment is stopped since success rates are minimal. The final goal of treatment is to achieve sustained virological response (SVR). It has been shown that relapse rates in patients achieving SVR are extremely rare.

He also mentioned small direct antiviral molecules，in particular HCV protease and polymerase inhibitors were under clinical development. These new drugs in combination with standard of care will reduce the duration of treatment in genotype 1 patients as well as improve the overall cure rates. For instance，the protease inhibitors, Telaprevir and Boceprevir are very promising to reduce duration of treatment from 48 to 24 weeks and improve SVR rates to 55 to 65 % in these patients.

Hopefully they also will help cure HCV in non-responders or relapsers to previous standard of care. Telaprevir in combination with standard of care made 41 % of non-respnders and 75 % of relapsers achieve SVR.

 在APSAL大会第四天，Michael P. Manns教授做了题为“Advances in Hepatitis C Infection”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Michael P. 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。