难治性丙型肝炎研究新进展

随着聚乙二醇化干扰素（IFN）的普及应用和慢性丙型肝炎规范化治疗的开展,其治愈率不断提高.但疗效不佳的慢性丙型肝炎患者不断积累,难治性慢性丙型肝炎患者成为临床医生必须面对的挑战.难治性丙型肝炎患者应当分为两类,第一类为“难治疗”性慢性丙型肝炎患者,该类患者由于宿主条件限制,不能耐受IFN联合利巴韦林（RBV）的标准治疗,如儿童和老年人、慢性肾功能衰竭患者等.第二类为“难治愈”性慢性丙型肝炎患者,该类患者可以耐受标准治疗方案,但按照应答指导的治疗原则（RGT）治疗后,效果仍然不佳或复发.本文就近年关于难治性丙型肝炎的研究进展,从难治性丙型肝炎的定义、机制、治疗诸方面作一综述.

The Current Status and Progress in Refractory Hepatitis C

With the extensive application of PEG-IFN and standardized treatment for chronic hepatitis C （CHC）,the cure rate improves.But patients with poor efficacy continue to accumulate,which is a big challenge for clinicians.Refractory hepatitis C should be divided into two categories.The first kind of patients,such as children and the elderly,patients with chronic renal failure,who can not tolerate standard therapy IFN combined with RBV.The second kind of patients is ＂difficult to cure＂ who has a poor therapeutic effect after standard treatment,in accordance with the principles of RGT.This review summarizes the current status and progress in refractory hepatitis C.