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【资讯翻译】AASLD Updates Hepatitis C Treatment Guidelines

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发表于 2015-7-8 09:30:01 | 显示全部楼层 |阅读模式
AASLD Updates Hepatitis C Treatment Guidelines
The American Association for the Study of Liver Diseases, along with other societies, has updated guidelines for the treatment of hepatitis C viral infection (HCV), including the use of direct-acting antiviral drugs. The new guidance was published online June 25 in Hepatology and is also posted online.

According to World Health Organization estimates, worldwide prevalence of chronic HCV infection is approaching 150 million. The Centers for Disease Control and Prevention reported US prevalence of 2.7 million, with 30,000 new acute cases in 2013. Health burden of HCV includes complications of cirrhosis or hepatocellular carcinoma.

"The good news is that HCV is now on the cusp of being a curable disease for...millions of Americans, many of whom are undiagnosed," writing panel cochair Gary Davis, MD, president of MedLogician Consulting, said in a news release. "The web-based Guidance document is an easy-to-use resource for practitioners treating HCV patients with novel antivirals."

The writing panel included 26 specialists in hepatology and infectious disease, as well as a patient advocate, to address HCV testing and linkage to care, initial therapy of HCV infection in treatment-naive patients, retreatment for patients refractory to prior therapy, and data for unique patient populations.

According to newly available data presented at the European Association for the Study of the Liver International Liver Congress 2015, the panel updated sections on When and In Whom to Initiate Therapy, Initial Treatment, Retreatment, Acute HCV Infection, and Unique Populations (HIV/HCV Coinfection, Decompensated Cirrhosis, and Renal Impairment).

"The Guidance is a living document that will continually be updated with evidence-based advice about how to best use the next generation of direct-acting antivirals and other treatment options," said American Association for the Study of Liver Diseases President-elect Keith Lindor, MD, from Arizona State University, Tempe. "Our role as associations of researchers and clinicians is to provide key information in the appropriate format to patients and those who care for them."

Some of the specific updates include the following:


 All patients with chronic HCV infection should be treated with the exception of those with short life expectancies as a result of comorbid conditions.

 Based on available resources, patients at high risk for liver-related complications should be given high priority for immediate treatment.

 Treatment-naive patients with HCV genotype 1a or 1b infection should receive daily sofosbuvir (400 mg) plus simeprevir (150 mg) for 12 weeks (no cirrhosis) or 24 weeks (cirrhosis without Q80K polymorphism), with or without weight-based ribavirin (from 1000 mg [<75 kg] to 1200 mg [>75 kg]).

 Treatment-naive patients with HCV genotype 3 infection should receive daily sofosbuvir (400 mg) and weight-based ribavirin plus weekly peginterferon for 12 weeks or, alternatively, daily sofosbuvir and weight-based ribavirin for 24 weeks if they are interferon-eligible.

 Treatment-naive patients with HCV genotype 5 or 6 infection should receive a daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) for 12 weeks or, alternatively, daily sofosbuvir and weight-based ribavirin plus weekly peginterferon for 12 weeks. Peginterferon and ribavirin with or without simeprevir for 24 to 48 weeks is not recommended.

 Patients with HCV genotype 1a or 1b infection without cirrhosis but with failure of prior peginterferon and ribavirin treatment should receive daily sofosbuvir (400 mg) plus simeprevir (150 mg) for 12 weeks.

Societies collaborating with the American Association for the Study of Liver Diseases to update these guidelines are the Infectious Diseases Society of America and the International Antiviral Society-USA.

信源地址:http://www.medscape.com/viewarticle/847552

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发表于 2015-7-8 13:01:04 | 显示全部楼层
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发表于 2015-7-10 01:41:01 | 显示全部楼层
                                                                         美国肝病研究学会(AASLD)更新丙型肝炎治疗指导方针
        美国肝病研究学会(AASLD)以及其他组织已经更新了丙型肝炎病毒(HCV)感染的治疗指导方针(包括了直接作用的抗病毒药物在内)。新指导方针已于6月25日的《肝病》网上出版,同时也已经网络发布。
       根据世界卫生组织(WHO)评估,全世界慢性HCV感染的人数即将达到1.5亿。疾病控制和预防中心报道说,美国的感染人数为270万,其中2013年新增急性病例3万例。HCV的健康风险在于肝硬化和肝细胞性肝癌。
      写作委员会副主席,MedLogician咨询中心首席,医学博士Gary Davis在一次新闻报道中说:“一个好消息是HCV现在处于成为一种可治愈性疾病的边缘......成千上万的美国人并没有进行确诊”。同时,他认为基于网络的指导文件对于使用新型抗病毒药物治疗HCV病人的操作人员是一种很容易使用的资源。
      写作委员会包括26位肝病和传染性疾病的专家以及一位患者代表,致力于说明HCV测试和相关护理,未治疗病人中第一次治疗的开展,以及对先前治疗方案表现顽固抵抗的病人的再治疗,以及特别的病人人群数据。
      根据欧洲肝病研究学会在2015年国际肝病大会发表的最新有效数据,委员会更新了以下几个章节的内容:什么时候和谁需要开始治疗,初治,复治,急性HCV感染和特殊人群(HIV/HCV共同感染患者,失代偿期肝硬化 患者以及肾损伤患者)。
        “该指导方针是一本活的文件,它会根据如何最好地利用下一代直接作用的抗病毒药物和其它治疗选择的循证意见进行持续更新,”美国肝病研究学会当选主席,来自坦佩亚利桑那州立大学的医学博士Keith Lindor说:“作为研究者和临床医生的联系者,我们的作用就是要用合适的方式给病人和那些关系他们的人提供关键信息”。
      一些具体的更新如下:
      除了由于共病状况寿命预期短的病人以外,所有的慢性HCV感染病人都需要进行治疗。
      基于可利用的资源,肝脏相关并发症高风险病人在即刻治疗方面应该给予高优先权。
      未治疗的HCV1a和1b型感染患者应该接受每天sofosbuvir (400 mg) 加simeprevir (150 mg) 的治疗,其中非肝硬化病人治疗周期为12周,而无Q80K多态性的肝硬化患者的治疗周期为24周。这些病人可以选择同时进行或者不进行体重依赖的ribavirin 治疗(从1000 mg [<75 kg]到1200 mg [>75 kg])。
      未治疗的HCV基因型3型感染患者应该接受为期12周的每天sofosbuvir (400 mg)和体重依赖的ribavirin,再加上每周一次的peginterferon治疗。或者如果病人适合食用干扰素治疗的,也可以采用每天的sofosbuvir和体重依赖ribavirin治疗,为期24周。
      未治疗的HCV基因型5或6型感染患者应该接受为期12周的每天剂量固定的 ledipasvir (90 mg)和sofosbuvir (400 mg)的联合治疗,或者为期12周的每天sofosbuvir和体重依赖ribavirin治疗加每周一次的peginterferon治疗。为期24到48周的Peginterferon和ribavirin治疗方案时不被推荐的(联合或不联合 simeprevir给药)。
      没有肝硬化但是对先前的peginterferon和ribavirin治疗失败的HCV1a和1b型感染患者应该接受为期12周的每天 sofosbuvir(400 mg) 加simeprevir (150 mg)的联合治疗。
与美国肝病研究学会共同合作来更新这些指导方针的协会有美国传染病协会和美国国际抗病毒协会。

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 楼主| 发表于 2015-7-13 10:48:23 | 显示全部楼层
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 楼主| 发表于 2015-7-13 10:48:59 | 显示全部楼层
“Guidelines” 临床上通常翻译为“指南”

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发表于 2015-7-13 20:56:26 | 显示全部楼层
卡壳了。。。。。。
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