基于长效干扰素和利巴韦林(ribavirin,RBV)的经典抗HCV疗法不良反应较大,疗效有待进一步提高.近年来抗HCV药物研发取得较快发展,以直接抗病毒药物(direct-acting antivirals,DAA)的研发最为活跃,在此基础上产生了多种新的抗HCV治疗策略.其中,针对病毒不同靶位的DAA联合治疗初露锋芒,Ⅱ期临床试验表明,不用干扰素,甚至不用RBV的DAA联合治疗可取得很好疗效,24周治疗后持续病毒学应答率最高可达100％,疗效可不受HCV基因型和患者IL-28B分型影响,患者耐受性通常良好.因此DAA联合治疗方案是今后治疗丙型肝炎的发展趋势.%Classical anti-HCV therapy based on a combination of pegylated interferon and ribavirin (RBV) has obvious side effects and its efficacy needs further improving. In recent years, rapid progress in anti-HCV drug development has been made, especially in the development of direct-acting antivirals (DAA), which has promoted the development of novel anti-HCV strategies. DAA combination therapy in terms of different viral targets shows great promise. Phase II clinical trials demonstrated that interferon -free, even RBV -free DAA combination therapy has achieved satisfactory efficacy. The 24 -week sustained virological response (SVR24) might reach 100%, HCV genotype and interleukin-28 genotype may have no effect on the therapeutic efficacy, and the patients are generally well tolerated. Therefore, DAA combination therapy is the development trend of the treatment of hepatitis C in the future.
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