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首页> 外文期刊>Clinics and research in hepatology and gastroenterology >Direct-acting antivirals for hepatitis C virus infections in patients co-infected with human immunodeficiency virus.
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Direct-acting antivirals for hepatitis C virus infections in patients co-infected with human immunodeficiency virus.

机译：在与人类免疫缺陷病毒共感染的患者中，丙型肝炎病毒感染的直接作用抗病毒药。

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Nearly three-quarters of human immunodeficiency virus-hepatitis C virus (HIV-HCV) coinfected patients in France currently need to be cured of their chronic HCV infection. The increase in sustained virological response rates obtained with the recently available HCV protease inhibitors in treatment-na?ve genotype-1 patients has generated considerable hope in these co-infected patients. However, several particularities (such as a higher baseline HCV load, more advanced liver fibrosis, frequent co-morbidities, and the risk of toxicity and drug-drug interactions) have not allowed the direct extrapolation of the results observed in HCV-monoinfected patients to patients with HIV-HCV co-infection. Yet, despite these uncertainties and the little available data from ongoing trials, several proposals can be made not only because the patients and drugs are ready and waiting, but also because the clock is ticking. In general, it can be advocated that HCV triple therapy should be offered to most HIV-infected patients with advanced liver fibrosis, but should be deferred or discussed on a case-by-case basis in those with mild-to-moderate fibrosis. However, such proposals rely on a relatively small amount of evidence and many questions are still pending, as studies in HIV-HCV co-infected patients have been late in coming and are several years behind those in HCV-monoinfected patients. Thus, this situation, in the context of more rapid and more severe infection, and lower response rates with standard care (pegylated interferon and ribavirin), along with the many potential drug-drug interactions (particularly with antiretroviral therapy), underscores the need for earlier evaluation of new strategies, schedules and new direct-acting antivirals in HIV-infected patients.
机译：在法国，近四分之三的人类免疫缺陷病毒-丙型肝炎病毒（HIV-HCV）合并感染患者需要治愈其慢性HCV感染。在未接受过治疗的基因型1的患者中，使用最近可用的HCV蛋白酶抑制剂获得的持续病毒学应答率的提高已在这些合并感染的患者中产生了巨大希望。但是，一些特殊因素（例如更高的基线HCV载量，更严重的肝纤维化，频繁的合并症以及毒性和药物相互作用的风险）无法将在HCV单感染患者中观察到的结果直接推算到HIV-HCV合并感染的患者。然而，尽管存在这些不确定性和正在进行的试验中的可用数据很少，但可以提出一些建议，不仅是因为患者和药物已经准备就绪并且正在等待，而且还因为时间紧迫。通常，可以提倡应为大多数患有晚期肝纤维化的HIV感染患者提供HCV三联疗法，但对于轻度至中度纤维化的患者，应逐案推迟或讨论。但是，此类提议依赖的证据相对较少，并且许多问题仍在等待中，因为针对HIV-HCV合并感染患者的研究较晚，并且比HCV单一感染患者的研究晚了几年。因此，在更快速，更严重的感染以及标准护理（聚乙二醇化干扰素和利巴韦林）的较低响应率以及许多潜在的药物相互作用（尤其是抗逆转录病毒疗法）的情况下，这种情况强调了对对HIV感染患者的新策略，时间表和新的直接作用抗病毒药物的早期评估。

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