Guidelines for the treatment of chronic hepatitis and cirrhosis due to hepatitis C virus infection for the fiscal year 2008 in Japan

被引：86

作者：

Kumada, Hiromitsu ^{[1
]}

Okanoue, Takeshi ^{[2
]}

Onji, Morikazu ^{[3
]}

Moriwaki, Hisataka ^{[4
]}

Izumi, Namiki ^{[5
]}

Tanaka, Eiji ^{[6
]}

Chayama, Kazuaki ^{[7
]}

Sakisaka, Shotaro ^{[8
]}

Takehara, Tetsuo ^{[9
]}

Oketani, Makoto ^{[10
]}

Suzuki, Fumitaka ^{[1
]}

Toyota, Joji ^{[11
]}

Nomura, Hideyuki ^{[12
]}

Yoshioka, Kentaro ^{[13
]}

Seike, Masataka ^{[14
]}

Yotsuyanagi, Hiroshi ^{[15
]}

Ueno, Yoshiyuki ^{[16
]}

机构：

[1] Toranomon Gen Hosp, Dept Hepatol, Tokyo, Japan

[2] Saiseikai Suita Hosp, Dept Gastroenterol & Hepatol, Suita, Osaka, Japan

[3] Ehime Univ, Dept Gastroenterol & Metabol, Grad Sch Med, Matsuyama, Ehime 790, Japan

[4] Gifu Univ, Dept Internal Med, Gifu, Japan

[5] Musashino Red Cross Hosp, Dept Gastroenterol & Hepatol, Musashino, Tokyo, Japan

[6] Shinshu Univ, Dept Internal Med, Matsumoto, Nagano 390, Japan

[7] Hiroshima Univ, Dept Med & Mol Sci, Div Frontier Med Sci, Programs Biomed Res,Grad Sch Biomed Sci, Hiroshima, Japan

[8] Fukuoka Univ, Sch Med, Dept Gastroenterol & Hepatol, Fukuoka 81401, Japan

[9] Osaka Univ, Dept Gastroenterol & Hepatol, Osaka, Japan

[10] Hlth Res Human & Environm Sci, Dept Digest & Lifestyle Related Dis, Kagoshima, Japan

[11] Sapporo Kosei Gen Hosp, Dept Gastroenterol, Sapporo, Hokkaido, Japan

[12] Shin Kokura Hosp, Ctr Liver Dis, Kitakyusyu City, Japan

[13] Fujita Hlth Univ, Div Liver Biliary Tract & Pancreas Dis, Dept Internal Med, Aichi, Japan

[14] Oita Univ, Dept Internal Med, Fac Med, Oita 87011, Japan

[15] Univ Tokyo, Dept Infect Dis, Tokyo, Japan

[16] Tohoku Univ, Div Gastroenterol, Grad Sch Med, Sendai, Miyagi 980, Japan

来源：

HEPATOLOGY RESEARCH | 2010年 / 40卷 / 01期

关键词：

chronic hepatitis; cirrhosis; hepatocellular carcinoma; hepatitis C virus; interferon; liver supportive therapy; pegylated interferon; ribavirin; RIBAVIRIN COMBINATION THERAPY; NORMAL SERUM AMINOTRANSFERASE; INTERFERON PLUS RIBAVIRIN; LONG-TERM INTERFERON; GENOTYPE; 1B; ANTIVIRAL THERAPY; EFFICACY; ACID; MONOTHERAPY; CARRIERS;

D O I：

10.1111/j.1872-034X.2009.00634.x

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

In the 2008 guidelines for the treatment of patients with chronic hepatitis C, pegylated interferon (Peg-IFN) combined with ribavirin for 48 weeks are indicated for treatment-naive patients infected with hepatitis C virus (HCV) of genotype 1. Treatment is continued for an additional 24 weeks (72 weeks total) in the patients who have remained positive for HCV RNA detectable by the real-time polymerase chain reaction at 12 weeks after the start of treatment, but who turn negative for HCV RNA during 13-36 weeks on treatment. Re-treatment is aimed to either eradicate HCV or normalize transaminase levels for preventing the development of hepatocellular carcinoma (HCC). For patients with compensated cirrhosis, the clearance of HCV RNA is aimed toward improving histological damages and decreasing the development of HCC. The recommended therapeutic regimen is the initial daily dose of 6 million international units (MIU) IFN continued for 2-8 weeks that is extended to longer than 48 weeks, if possible. IFN dose is reduced to 3 MIU daily in patients who fail to clear HCV RNA by 12 weeks for preventing the development of HCC. Splenectomy or embolization of the splenic artery is recommended to patients with platelet counts of less than 50 x 103/mm3 prior to the commencement of IFN treatment. When the prevention of HCC is at issue, not only IFN, but also liver supportive therapy such as stronger neo-minophagen C, ursodeoxycholic acid, phlebotomy, branched chain amino acids (BCAA), either alone or in combination, are given. In patients with decompensated cirrhosis, by contrast, reversal to compensation is attempted.

引用

页码：8 / 13

页数：6