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RISS 인기검색어
- 검색키워드
- 저자 : ( Liver Diseases Branch ) (검색결과 2 건)
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Perspective on the management of hepatitis C in the DAA era
( T Jake Liang ),( Liver Diseases Branch ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-
The therapy of hepatitis C has experienced a tremendous growth and improvement over the last two decades. The initial monotherapy with interferon α had a dismal result of less than 10% sustained virologic response rate. The combination of interferon α with an old antiviral drug, ribavirin, led to a remarkable increase in the response rate. Next the improved formulation of pegylated interferon resulted in an even higher rate of treatment response. But for many years, the scientific community struggled with the development of new therapeutic regimens to improve on the response rate and to minimize the side effects from interferon based therapy. Basic scientific advances came to the rescue. Based on the knowledge of the viral life cycle and gene functions, a new era of hepatitis C therapy is dawning. With years of discovery work, preclinical testing and finally clinical trials, two direct acting antivirals (DAAs) targeting the protease function of the virus, telaprevir and boceprevir, were approved by the FDA last year. Many other DAAs, closely following behind, would likely be approved in the next few years. The DAAs, in combination with peginterferon and ribavirin, can generate a sustained virologic response rate of more than 60% in HCV genotype 1 patients. The DAAs will likely change the landscape of treatment for hepatitis C. They are associated with more side effects than the standard peginterferon and ribavirin combination, and therefore need careful management. The DAAs also cannot be used alone and should only be used in genotype 1 patients. The DAAs are not approved for liver transplant, HIV/HCV co-infected, hemodialysis or pediatric patients. Deviation from recommended regimens may result in poorer response and potential unanticipated morbidity. Many questions regarding the DAAs remain and need to be adequately addressed, As the armamentarium of DAAs grows for therapy of hepatitis C in the next few years, it will be imperative to develop a rigorous evidence based algorithm and set of recommendations for the use of these drugs.
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Perspective on the management of hepatitis C in the DAA era
( T Jake Liang ),( Liver Diseases Branch ),( Niddk ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1
The therapy of hepatitis C has experienced a tremendous growth and improvement over the last two decades. The initial monotherapy with interferon?α had a dismal result of less than 10% sustained virologic response rate. The combination of interferon?α with an old antiviral drug, ribavirin, led to a remarkable increase in the response rate. Next the improved formulation of pegylated interferon resulted in an even higher rate of treatment response. But for many years, the scientific community struggled with the development of new therapeutic regimens to improve on the response rate and to minimize the side effects from interferon based therapy. Basic scientific advances came to the rescue. Based on the knowledge of the viral life cycle and gene functions, a new era of hepatitis C therapy is dawning. With years of discovery work, preclinical testing and finally clinical trials, two direct acting antivirals (DAAs) targeting the protease function of the virus, telaprevir and boceprevir, were approved by the FDA last year. Many other DAAs, closely following behind, would likely be approved in the next few years. The DAAs, in combination with peginterferon and ribavirin, can generate a sustained virologic response rate of more than 60% in HCV genotype 1 patients. The DAAs will likely change the landscape of treatment for hepatitis C. They are associated with more side effects than the standard peginterferon and ribavirin combination, and therefore need careful management. The DAAs also cannot be used alone and should only be used in genotype 1 patients. The DAAs are not approved for liver transplant, HIV/HCV co-infected, hemodialysis or pediatric patients. Deviation from recommended regimens may result in poorer response and potential unanticipated morbidity. Many questions regarding the DAAs remain and need to be adequately addressed. As the armamentarium of DAAs grows for therapy of hepatitis C in the next few years, it will be imperative to develop a rigorous evidence?based algorithm and set of recommendations for the use of these drugs.
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