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Portación crónica de VHB, HBeAg negativo
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2007-02-01 DOI: 10.1038/ncpgasthep0865
Morris Sherman
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引用次数: 0
Hombre de 42 años con hepatitis B crónica, HBeAg positivo 42岁男性，慢性乙型肝炎，HBeAg阳性
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2007-02-01 DOI: 10.1038/NCPGASTHEP0864
M. Silva
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引用次数: 0
Introducci|[oacute]|n
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2007-02-01 DOI: 10.1038/NCPGASTHEP0862
A. Gadano
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引用次数: 0
Nuevas estrategias de tratamiento en la hepatitis B crónica 慢性乙型肝炎的新治疗策略
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2007-02-01 DOI: 10.1038/NCPGASTHEP0863
Morris Sherman
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引用次数: 0
Tratamiento de la hepatitis B grave en el contexto del pre y pos trasplante hepático 肝移植前后严重乙型肝炎的治疗
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2007-02-01 DOI: 10.1038/ncpgasthep0866
Morris Sherman
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引用次数: 0
Emerging strategies for pegylated interferon combination therapy. 聚乙二醇化干扰素联合治疗的新策略。
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2007-01-01 DOI: 10.1038/ncpgasthep0691
Eugene R Schiff

Several advances afford promise for improving the management of hepatitis C virus (HCV) infection. Current therapies primarily target the immune system; the now proven ability to culture the entire virus in vitro could ultimately facilitate the identification of therapies directly targeting viral replication. Several therapies are presently in development. Taribavirin hydrochloride (Viramidine, Valeant Pharmaceutical International, Singapore), a ribavirin prodrug, has shown promise, although the rate of sustained virologic response with this agent has been disappointing. The next generation of antivirals will consist of protease and polymerase inhibitors, a number of which are undergoing investigation, initially as monotherapy and subsequently in combination with pegylated interferon and ribavirin. Challenges include the prevention of recurrent HCV infection in liver-transplant recipients and development of a safe and effective HCV vaccine.

一些进展为改善丙型肝炎病毒(HCV)感染的管理提供了希望。目前的治疗主要针对免疫系统;目前已证实的在体外培养整个病毒的能力，可能最终有助于确定直接针对病毒复制的治疗方法。目前正在开发几种治疗方法。盐酸塔利巴韦林(Viramidine, Valeant Pharmaceutical International, Singapore)是一种利巴韦林前药，虽然这种药物的持续病毒学应答率令人失望，但它已显示出前景。下一代抗病毒药物将包括蛋白酶和聚合酶抑制剂，其中一些正在进行研究，最初作为单药治疗，随后与聚乙二醇化干扰素和利巴韦林联合使用。挑战包括预防肝移植受者复发性丙肝病毒感染和开发安全有效的丙肝病毒疫苗。
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引用次数: 16
New paradigms in the management of hepatitis C virus co-infections. 丙型肝炎病毒合并感染管理的新模式。
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2007-01-01 DOI: 10.1038/ncpgasthep0692
Kenneth E Sherman

Liver disease has emerged as a major contributor to morbidity and mortality in patients with HIV infection. Hepatitis C virus (HCV) infection is a key element in the etiology of liver-associated injury in this population. Increased rates of fibrotic progression have been described and are mediated by alcohol use, the severity of immunosuppression, the use of antiretroviral therapy, and other factors. Large clinical trials have demonstrated the efficacy of treatment with pegylated interferon plus ribavirin and highlighted issues related to management of patients with HIV/HCV co-infection. Although treatment for HCV infection in this group remains a challenge, achievement of a sustained virologic response is feasible in approximately 35% of patients. Treatment must be individualized and attention must be paid to the potential for drug-drug interactions.

肝病已成为艾滋病毒感染患者发病率和死亡率的主要原因。丙型肝炎病毒(HCV)感染是该人群肝相关损伤病因学的关键因素。已有报道称，纤维化进展率的增加是由饮酒、免疫抑制的严重程度、抗逆转录病毒治疗的使用和其他因素介导的。大型临床试验已经证明了聚乙二醇化干扰素加利巴韦林治疗的有效性，并强调了与HIV/HCV合并感染患者管理相关的问题。尽管在这一群体中治疗HCV感染仍然是一个挑战，但在大约35%的患者中实现持续的病毒学反应是可行的。治疗必须个体化，必须注意药物-药物相互作用的可能性。
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引用次数: 9
Customizing treatment to patient populations. 针对患者群体定制治疗方案。
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2007-01-01 DOI: 10.1038/ncpgasthep0693
Robert S Brown

Combination treatment with pegylated interferon plus ribavirin is the most effective therapy for patients with chronic hepatitis C virus (HCV); however, responses are less than optimal in some subpopulations of patients. Emerging insights are suggesting that viral kinetics can be used to predict response. The rapidity of response has been shown to be a more important predictor of sustained virologic response than the duration of therapy. In patients with HCV genotype 2 or 3, shorter durations of treatment might be sufficient in rapid responders and could minimize the risk of toxic effects. Weight-based dosing of ribavirin has emerged as another important consideration. This strategy seems to be most important for difficult-to-treat patients with HCV genotype 1 or advanced fibrosis, and for African-Americans, and is possibly important for patients who have genotype 3 and a high viral load. Re-treatment of nonresponders with interferon-based therapy has been associated with low rates of sustained virologic response. Consensus interferon might offer a new option for patients who do not achieve an early treatment response to standard or pegylated interferon plus ribavirin.

聚乙二醇化干扰素加利巴韦林联合治疗是慢性丙型肝炎病毒(HCV)患者最有效的治疗方法;然而，在某些亚群患者中，反应并不理想。新出现的见解表明，病毒动力学可以用来预测反应。反应速度已被证明是比治疗时间更重要的持续病毒学反应预测指标。在HCV基因型2或3的患者中，较短的治疗时间对于快速反应者来说就足够了，并且可以将毒性作用的风险降到最低。体重为基础的利巴韦林剂量已成为另一个重要的考虑。这种策略似乎对难以治疗的HCV基因型1或晚期纤维化患者和非裔美国人最为重要，对基因型3和高病毒载量的患者可能也很重要。以干扰素为基础的治疗对无应答者的再治疗与持续病毒学应答率低有关。共识干扰素可能为那些对标准或聚乙二醇干扰素加利巴韦林没有达到早期治疗反应的患者提供一个新的选择。
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引用次数: 10
Introduction: advances in antiviral therapy for chronic hepatitis C infection—the influence of genotype and HIV co-infection 前言:慢性丙型肝炎病毒感染的抗病毒治疗进展——基因型和HIV合并感染的影响
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2007-01-01 DOI: 10.1038/NCPGASTHEP0690
E. Schiff
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引用次数: 1
Treatment of chronic hepatitis B 治疗慢性乙型肝炎
Nature Clinical Practice. Gastroenterology & Hepatology
Pub Date : 2005-01-04 DOI: 10.24871/6120059-15
P. Pramita, R. Gani, A. Sulaiman
Chronic hepatitis B is still a major health problem in Indonesia. Unfortunately, to date, treatment of chronic HBV (Hepatitis B virus) infection had not shown satisfactory Result. Monotherapy with alpha interferon or lamivudine have been widely used as treatment of chronic HBV. However, treatment response to Alpha interferon in Asian people was not satisfactory (15% - 20%), while monotherapy with lamivudine was not sufficient to eradicate HBV in chronically infected patients and commonly induce drug resistance. The occurrence of chronic hepatitis B resistant to lamivudine had encouraged development of newer agents such as adefovir, entecavir, emtricitabine and nucleoside analog. New therapeutic strategy using combination therapy should be considered if there is no sufficient response to monotherapy. Keywords : Treatment, chronic hepatitis B, combination therapy
慢性乙型肝炎在印度尼西亚仍然是一个主要的健康问题。不幸的是，迄今为止，慢性HBV(乙型肝炎病毒)感染的治疗并未显示出令人满意的结果。干扰素或拉米夫定的单药治疗已被广泛用于慢性HBV的治疗。然而，亚洲人对α干扰素的治疗反应并不令人满意(15% - 20%)，而拉米夫定单药治疗不足以根除慢性感染患者的HBV，而且通常会引起耐药性。慢性乙型肝炎对拉米夫定耐药的发生促进了阿德福韦、恩替卡韦、恩曲他滨和核苷类似物等新药的开发。如果对单药治疗没有足够的反应，应考虑采用联合治疗的新治疗策略。关键词:治疗，慢性乙型肝炎，联合治疗
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