논문KCI 등재
경구 C형 간염 치료제를 이용한 만성 C형 간염의 치료
Treatment of Chronic Hepatitis C Using Newly Developed Oral Antiviral Agents
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초록
만성 C형 간염 치료에서 인터페론 없는 경구 치료법은 치료기간이 짧고 복용이 간편하며 부작용이 없는 장점뿐만 아니라 거의 100%에 가까운 완치율을 보여준다는 점에서 크게 기대된다. 국내에서도 수년 내 인터페론이 포함된 치료법은 경구 치료제로 바뀔 것이다. 하지만 진행성 간경변증, HIV와 HCV 의 동시감염, 신부전이나 이식 후 환자들에서는 추가 연구결과들이 필요하다. 무엇보다도 고가의 치료 비용은 새로운 경구 치료제에 대한 기대감보다는 실제 임상 적용의 어려움과 걱정을 앞서게한다. 국내에 도입될 경구 치료제들이 현실적인 가격으로 많은 국내 만성 C형 간염 환자들에게 완치의 기쁨을 안겨주길기대한다.
Abstract
Standard care for chronic hepatitis C has been a combination of pegylated interferon-alpha and ribavirin, although this treatment has suboptimal antiviral efficacy and significant adverse events. The hepatitis C virus treatment landscape has been transformed recently by the development of direct-acting antiviral agents (DAAs) that target NS3 protease, NS5A protein, and NS5B polymerase. Several DAAs showed potent antiviral activity leading to increased rates of sustained virological response (SVR), even in difficult- to-treat patients such as older patients and those with advanced liver disease and prior failed peg-interferon/ribavirin treatment. Use of multiple DAAs without pegylated interferon has shown dramatically high SVR rates (up to nearly 100%) with negligible side effects. Interferon-free regimens are close to becoming the new standard of care for patients with chronic hepatitis C in USA and Europe. Similarly, several DAAs are near clinical use in Korea. This review discusses DAAs that have been approved or are under investigation for approval in Korea.
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