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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Hepatitis C and human immunodeficiency virus coinfection in the era of direct‐acting antiviral agents: No longer a difficult‐to‐treat population
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Hepatitis C and human immunodeficiency virus coinfection in the era of direct‐acting antiviral agents: No longer a difficult‐to‐treat population

机译：丙型肝炎和人类免疫缺陷病毒在直效抗病毒剂时代的繁殖：不再是难以治疗的人群

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The treatment of chronic hepatitis C (HCV) in human immunodeficiency virus 1 (HIV)–infected individuals has been historically marked by low sustained virologic response (SVR) rates in comparison to those without HIV infection, resulting in the Food and Drug Administration labeling those coinfected as a “special population with an unmet medical need.” We systematically reviewed the treatment of chronic HCV infection in those infected with HIV. We propose that with the advent of direct‐acting antiviral (DAA) agents, patients coinfected with HCV and HIV have similar SVR rates as HCV‐monoinfected persons and that DAAs address an unmet medical need in this population. A review was performed using Medical Subject Heading terms within the PubMed, EMBASE, and Cochrane Library databases to search for studies dated between January 2004 and July 2017. Keywords used in the study included “hepatitis C,” “HIV,” “coinfection,” and “direct‐acting antiviral.” SVR rates for those with HCV and HIV coinfection treated with interferon‐based therapies were substantially lower that SVR rates of HCV‐monoinfected individuals. The advent of DAA agents has resulted in similar SVR rates between monoinfected and coinfected individuals, with SVR 93%. These medications have been demonstrated to have improved safety, efficacy, and tolerability in comparison to interferon‐based regimens. Conclusion : The designation of a “special population” for those with coinfection requires reconsideration; DAA therapies have resulted in similarly high rates of SVR for HCV infection in those with and without HIV infection; despite these improvements, however, clinicians must be cognizant of negative predictors of SVR and barriers to treatment that may be more common in the coinfected population. (H epatology 2018;67:847–857)
机译：人免疫缺陷病毒病毒1（HIV）的慢性丙型肝炎（HCV）的治疗在历史上标志着与没有艾滋病毒感染的人的低持续的病毒学反应（SVR）率，导致食物和药物管理标记将作为“未满足的医疗需求的特殊人口”。我们系统地审查了艾滋病毒感染者慢性HCV感染的治疗方法。我们提出随着直接作用的抗病毒药物（DAA）药剂的出现，与HCV和HIV一起携带的患者具有与HCV-单引发人员相似的SVR速率，并且DAAS在该人群中解决了未满足的医疗需求。在PubMed，Embase和Cochrane图书馆数据库内使用医疗主题标题术语进行审查，以搜索2017年1月至2017年1月至2017年7月期间的研究。该研究中使用的关键词包括“丙型肝炎”，“艾滋病毒”，“艾滋病毒”，“互联”和“直接抗病毒品”。用干扰素的疗法治疗的HCV和HIV辛凝聚的SVR速率显着降低了HCV-单链型个体的SVR速率。 DAA代理的出现导致单染料和焦化的个体之间的类似SVR率，SVR＆GT; 93％。与基于干扰素的方案相比，已经证明这些药物具有改善的安全性，功效和可耐受性。结论：为繁殖团的“特殊人口”的指定需要重新考虑; Daa疗法导致在有和没有艾滋病毒感染的人中的HCV感染类似的高SVR率;然而，尽管这些改善，临床医生必须认识到SVR的阴性预测因子和治疗的障碍物中可能在繁殖的人群中更常见。 （H Popatology 2018; 67：847-857）

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