Advances in the treatment of hepatitis B virus/hepatitis C virus coinfection

被引:24
|
作者
Sagnelli, Evangelista [1 ]
Pisaturo, Mariantonietta [2 ]
Martini, Salvatore [3 ]
Sagnelli, Caterina [4 ]
Filippini, Pietro [1 ]
Coppola, Nicola [1 ]
机构
[1] Univ Naples 2, Div Infect Dis, Dept Mental Hlth & Publ Med, I-80131 Naples, Italy
[2] AORN St Anna & San Sebastiano Caserta, Div Infect Dis, I-81100 Caserta, Italy
[3] Univ Naples 2, Dept Mental Hlth & Publ Med, Sect AIDS Diag & Therapy, I-80131 Naples, Italy
[4] Univ Naples 2, Dept Clin & Expt Med & Surg F Magrassi & A Lanzar, I-80131 Naples, Italy
关键词
hepatitis B virus/hepatitis C virus coinfection; hepatitis B virus/hepatitis C virus coinfection treatment; hepatitis B virus/hepatitis C virus epidemiology; hepatitis B virus/hepatitis C virus/HIV interaction; CHRONIC LIVER-DISEASE; HEPATOCELLULAR-CARCINOMA; CHRONIC CARRIERS; PEGINTERFERON ALPHA-2A; PROTEASE INHIBITOR; VIRAL INTERACTION; INTERFERON-ALPHA; HBV SUPERINFECTION; NATURAL-HISTORY; HCV COINFECTION;
D O I
10.1517/14656566.2014.913571
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: Patients with chronic hepatitis B virus (HBV)/hepatitis C virus (HCV) coinfection are at a high risk of developing liver cirrhosis and hepatocellular carcinoma, and consequently, warrant effective treatment. Areas covered: Effective treatment should eradicate HCV infection and inhibit HBV replication but without serious adverse reactions. Careful evaluation of disease progression, predominance of one virus over another, comorbidities and concomitant hepatitis delta virus and/or HIV infection are essential for better therapy choices. In the case of HCV predominance, Peg-interferon plus ribavirin with or without a first-generation directly acting antiviral (DAA) should be the first choice, but future treatments will be DAA-based and interferon-free. In the case of HBV predominance, tenofovir or entecavir should be part of treatment. Patients should be closely monitored for early identification and treatment of HCV or HBV reactivation. Expert opinion: High potency and high genetic barrier nucleos(t)ide analogues to inhibit HBV replication have been used for years, with no urgency for new drugs. Several DAAs for interferon-free therapy for HCV eradication will be available in the near future. We hope that the high cost of these drugs will not be a limitation to their use in developing countries. Further investigation of HBV/HCV interaction is needed before and during the administration of new therapies.
引用
收藏
页码:1337 / 1349
页数:13
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