慢性丙型肝炎合并肾功能不全患者直接抗病毒药物治疗的选择

陈建宏; 徐小元

doi:10.3969/j.issn.1001-5256.2018.02.007

慢性丙型肝炎合并肾功能不全患者直接抗病毒药物治疗的选择

DOI: 10.3969/j.issn.1001-5256.2018.02.007

北京大学第一医院感染疾病科

基金项目:

十二五重大专项(2012ZX10002003-004-003)；国家自然科学基金(81373056)；

详细信息

中图分类号: R512.63;R692
计量
- 文章访问数: 345
- HTML全文浏览量: 12
- PDF下载量: 104
- 被引次数: 0
出版历程
- 出版日期: 2018-02-20

Selection of direct-acting antiviral agents in treatment of chronic hepatitis C patients with renal dysfunction

Department of Infectious Diseases, Peking University First Hospital

Research funding:

摘要

摘要:
HCV感染在肾功能不全（RD）患者中较常见,尤其是在终末期肾病进行血液透析（HD）的患者中,感染率明显高于普通人群,肝脏疾病的发生率及病死率升高。直接抗病毒药物在慢性丙型肝炎的治疗中取得了超过90%的持续病毒学应答和较少的不良事件。在合并RD和HD患者中推荐应用grazoprevir/elbasvir、paritaprevir/ritonavir+ombitasvir+dasabuvir、glecaprevir/pibrentasvir或daclartasvir+asunaprevir等治疗方案,不建议推荐以sofosbuvir为基础的治疗方案。
- 肝炎,丙型,慢性 /
- 肾功能不全 /
- 血液透析滤过 /
- 抗病毒药
Abstract:
The incidence of hepatitis C virus infection is commonly seen in patients with renal dysfunction (RD) , especially those with end-stage renal disease on hemodialysis (HD) , among whom the incidence and mortality of liver diseases increase.The development of direct-acting antiviral agents has revolutionized the therapy for chronic hepatitis C (CHC) with a sustained virologic response rate of > 90% and a low rate of adverse events.Grazoprevir/elbasvir, paritaprevir/ritonavir + ombitasvir + dasabuvir, glecaprevir/pibrentasvir, or daclatasvir + asunaprevir regimen is recommended in CHC patients with RD and HD, while the sofosbuvir-based regimen is not recommended.
- hepatitis C chronic /
- renal insufficiency /
- hemodiafiltration /
- antiviral agents

HTML全文

参考文献(19)

[1]WU HD, ZHOU HJ, WANG ZH.Application of direct-acting antiviral agents in patients with severe chronic renal insufficiency complicated by hepatitis C virus infection[J].Chin J Nephrol, 2017, 33 (1) :69-72. (in Chinese) 吴杭迪, 周惠娟, 王朝晖.直接抗病毒药物在重度慢性肾功能不全合并丙型肝炎病毒感染人群中的应用[J].中华肾脏病杂志, 2017, 33 (1) :69-72.

[2]LI MR, XU XY.Recent progress in direct-acting antiviral agents for chronic hepatitis C[J].J Clin Hepatol, 2014, 30 (6) :493-495. (in Chinese) 李敏然, 徐小元.抗HCV小分子化合物的研究[J].临床肝胆病杂志, 2014, 30 (6) :493-495.

[3]COPPOLA N, MINICHINI C, STARACE M, et al.Clinical impact of the hepatitis C virus mutations in the era of directly acting antivirals[J].J Med Virol, 2016, 88 (10) :1659-1671.

[4]SUDA G, OGAWA K, KIMURA M, et al.Novel treatment of hepatitis C virus infection for patients with renal impairment[J].J Clin Transl Hepatol, 2016, 4 (4) :320-327.

[5]SMOLDERS EJ, de KANTER CT, van HOEK B, et al.Pharmacokinetics, efficacy, and safety of hepatitis C virus drugs in patients with liver and/or renal impairment[J].Drug Saf, 2016, 39 (7) :589-611.

[6]ROTH D, NELSON DR, BRUCHFELD A, et al.Grazoprevir plus elbasvir in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and stage 4-5 chronic kidney disease (the C-SURFER study) :a combination phase 3study[J].Lancet, 2015, 386 (10003) :1537-1545.

[7]European Association for the Study of the Liver.EASL recommendations on treatment of hepatitis C 2016[J].J Hepatol, 2017, 66 (1) :153-194.

[8]POCKROS PJ, REDDY KR, MANTRY PS, et al.Efficacy of direct-acting antiviral combination for patients with hepatitis C virus genotype 1 infection and severe renal impairment or end-stage renal disease[J].Gastroenterology, 2016, 150 (7) :1590-1598.

[9]CHOLONGITAS E, PIPILI C, PAPATHEODORIDIS GV.Interferon-free regimens in patients with hepatitis C infection and renal dysfunction or kidney transplantation[J].World J Hepatol, 2017, 9 (4) :180-190.

[10]LIN CW, DUTTA S, DING B, et al.Pharmacokinetics, safety, and tolerability of glecaprevir and pibrentasvir in healthy white, Chinese, and Japanese adult subjects[J].J Clin Pharmacol, 2017, 57 (12) :1616-1624.

[11]GANE E, LAWITZ E, PUGATCH D, et al.Glecaprevir and Pibrentasvir in patients with HCV and severe renal impairment[J].N Engl J Med, 2017, 377 (15) :1448-1455.

[12]KUMADA H, WATANABE T, SUZUKI F, et al.Efficacy and safety of glecaprevir/pibrentasvir in HCV-infected Japanese patients with prior DAA experience, severe renal impairment, or genotype 3 infection[J].J Gastroenterol, 2017.[Epub ahead of print]

[13]GARIMELLA T, WANG R, LUO WL, et al.Single-dose pharmacokinetics and safety of daclatasvir in subjects with renal function impairment[J].Antivir Ther, 2015, 20 (5) :535-543.

[14]KAWAKAMI Y, IMAMURA M, IKEDA H, et al.Pharmacokinetics, efficacy and safety of daclatasvir plus asunaprevir in dialysis patients with chronic hepatitis C:pilot study[J].J Viral Hepat, 2016, 23 (11) :850-856.

[15]ELEY T, GARIMELLA T, LI W, et al.Asunaprevir:a review of preclinical and clinical pharmacokinetics and drug-drug interactions[J].Clin Pharmacokinet, 2015, 54 (12) :1205-1222.

[16]SUDA G, KUDO M, NAGASAKA A, et al.Efficacy and safety of daclatasvir and asunaprevir combination therapy in chronic hemodialysis patients with chronic hepatitis C[J].J Gastroenterol, 2016, 51 (7) :733-740.

[17]OUWERKERK-MAHADEVAN S, BEUMONT-MAUVIEL M, MORTIER S, et al.Evaluation of the pharmacokinetics and renal excretion of simeprevir in subjects with renal impairment[J].Drugs R D, 2015, 15 (3) :261-270.

[18]SORIANO V, BENITEZ-GUTIERREZ L, ARIAS A, et al.Evaluation of sofosbuvir, velpatasvir plus voxilaprevir as fixed-dose co-formulation for treating hepatitis C[J].Expert Opin Drug Metab Toxicol, 2017, 13 (9) :1015-1022.

[19]SAXENA V, KORAISHY FM, SISE ME, et al.Safety and efficacy of sofosbuvir-containing regimens in hepatitis C-infected patients with impaired renal function[J].Liver Int, 2016, 36 (6) :807-816.

施引文献

资源附件(0)

访问统计