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Ribavirin:Past,present and future

Ribavirin:Past,present and future

作     者:Véronique Loustaud-Ratti Marilyne Debette-Gratien Jérémie Jacques Sophie Alain Pierre Marquet DenisSautereau Annick Rousseau Paul Carrier 

作者机构:Fédération HépatologieCHU Dupuytren87042 LimogesFrance Service d’HépatogastroentérologieCHU Limoges87042 LimogesFrance U850 INSERMUniversitéde LimogesCHU Limoges87042 LimogesFrance Service de Bactériologie VirologieCHU Limoges87042 LimogesFrance U1092 INSERMUniversitéde LimogesCHU Limoges87042 LimogesFrance Service de PharmacologieCHU Limoges87042 LimogesFrance 

出 版 物:《World Journal of Hepatology》 (世界肝病学杂志(英文版)(电子版))

年 卷 期:2016年第8卷第2期

页      面:123-130页

学科分类:1007[医学-药学(可授医学、理学学位)] 1002[医学-临床医学] 10[医学] 

主  题:Ribavirin Hepatitis C Peginterferon Directacting antiviral agents 

摘      要:Before the advent of direct acting antiviral agents(DAAs) ribavirin, associated to pegylated-interferon played a crucial role in the treatment of chronic hepatitis C, preventing relapses and breakthroughs. In the present era of new potent DAAs, a place is still devoted to the drug. Ribavirin associated with sofosbuvir alone is efficient in the treatment of most cases of G2 infected patients. All options currently available for the last difficult-to-treat cirrhotic G3 patients contain ribavirin. Reducing treatment duration to 12 wk in G1 or G4 cirrhotic compensated patients is feasible thanks to ribavirin. Retreating patients with acquired anti NS5 A resistance-associated variants using ribavirin-based strategies could be useful. The addition of ribavirin with DAAs combinations however, leads to more frequent but mild adverse events especially in cirrhotic patients. Preliminary data with interferon-free second generation DAAs combinations without ribavirin suggest that future of the drug is jeopardized even in difficult-totreat patients: The optimization of ribavirin dosage according to an early monitoring of blood levels has been suggested to be relevant in double therapy with peginterferon or sofosbuvir but not with very potent combinations of more than two DAAs.

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