臨牀消化器内科 Vol.27 No.11(3)


特集名 C型肝炎治療の最前線
題名 テラプレビル3剤併用療法の効果と予測因子
発刊年月 2012年 10月
著者 熊田 博光 虎の門病院肝臓センター
【 要旨 】 HCV genotype 1における新規C型肝炎治療薬のテラプレビル/ペグインターフェロン/リバビリン併用療法は初回治療例や前治療再燃例で高率なSVRを期待できる.さらに,宿主要因のIL28B遺伝子多型とウイルス要因のCoreアミノ酸置換を組み合わせることでより詳細な治療前効果予測が可能となる.しかし難治な前治療無効例は,肝発癌リスクを考慮して治療適応症例を慎重に絞り込むことが重要である.そのうえで,Coreアミノ酸置換,AFP値,前治療反応性を組み合わせて詳細な治療前効果予測を行う必要がある.
Theme The Forefront of Hepatitis C Treatment
Title Treatment Efficacy and Predictors to Triple Therapy of Telaprevir, Peginterferon and Ribavirin
Author Hiromitsu Kumada Department of Hepatology, Toranomon Hospital
[ Summary ] Triple therapy of telaprevir with peginterferon and ribavirin significantly improves rates of sustained virological response in patients with HCV genotype 1 infection, who had not received previous treatment, and patients who had a previous relapse. Amino acid substitution of HCV core region and IL28B genotype are also useful as predictors of viral response to triple therapy. However, the sustained virological response rates to triple therapy are lower in patients who had a previous non response, so the suitable patients for triple therapy should be selected based on the risk of hepatocellular carcinoma. Furthermore, amino acid substitution of core region, alpha-fetoprotein level, and type of previous response could predict viral response to triple therapy in patients who had a previous non response.
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