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首页> 外文期刊>Seminars in Gastrointestinal Disease >Chronic hepatitis C: retreatment of relapsers. An evidence-based approach.
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Chronic hepatitis C: retreatment of relapsers. An evidence-based approach.

机译：慢性丙型肝炎：复发者的再治疗。基于证据的方法。

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摘要

Post-treatment relapse remains a major issue in the long-term management of chronic hepatitis C. Many studies have been conducted to identify the ideal therapy that would increase the cost-effectiveness of retreatment in the individual patient. Although the conclusions of two consensus conferences for the retreatment of relapse of chronic hepatitis C have been published recently, several important issues still remain unanswered. We reviewed the available data by an evidence-based approach and conclude the following: (1) patients should be retreated with a combination of interferon (IFN) and ribavirin for 6 months if there are no contraindications to ribavirin; (2) the excellent tolerability and the lesser expense of retreatment with IFN monotherapy makes it a low-cost option for patients who have transiently cleared HCV-RNA during the first IFN course, and a primary indication for those who are contraindications to ribavirin or are likely to experience adverse events under ribavirin; (3) relapsers retreated with monotherapy must receive a high dose of IFN; and (4) patients with cirrhosis should not be retreated with IFN alone. More data, particularly on the long-term course of patients retreated with combination therapy, are needed before setting guidelines for retreatment of relapsers.
机译：在慢性丙型肝炎的长期治疗中，治疗后复发仍然是一个主要问题。已经进行了许多研究，以找出理想的治疗方法，该方法可以提高个体患者再次治疗的成本效益。尽管最近发表了两次关于治疗慢性丙型肝炎复发的共识性会议的结论，但仍有几个重要问题尚未得到解答。我们通过循证方法回顾了现有数据，得出以下结论：（1）如果没有利巴韦林的禁忌症，应将干扰素（IFN）和利巴韦林联合治疗6个月; （2）IFN单一疗法的优异耐受性和再治疗的较少费用，使其成为在IFN首疗过程中短暂清除HCV-RNA的患者的低成本选择，并且是对利巴韦林禁忌症或在利巴韦林下可能发生不良事件; （3）单药治疗的复发者必须接受大剂量的IFN; （4）肝硬化患者不应仅接受IFN治疗。在为复发者制定再治疗指南之前，需要更多数据，特别是有关接受联合治疗的患者的长期病程。

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