Are metabolic factors still important in the era of direct antiviral agents in patients with chronic hepatitis C?
Are metabolic factors still important in the era of direct antiviral agents in patients with chronic hepatitis C?作者机构：Gastroenterology UnitDepartment of Internal MedicineSan Paolo Hospital
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2013年第19卷第41期
页 面：6947-6956页
核心收录：
学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学]
主 题：Metabolic factors Insulin resistance Direct antiviral agents Chronic hepatitis C
摘 要：The high rate of sustained viral response(SVR)to boceprevir or telaprevir-based triple therapy in hepatitis C(HCV)-related,non-cirrhotic na ve patients or relapsers to previous antiviral treatment leads clinicians to believe that the impact of metabolic host factors on SVR is minimal when triple therapy is used,unlike what is observed with the peginterferon and ribavirin *** concept is strongly expressed by some opinion leaders on the basis of the data derived from subanalyses of registrative trials as well as from a post-hoc analysis of the phaseⅡC208 clinical *** perception of unrestrainable therapeutic success with the use of newer,more powerful antivirals is now reinforced by the brilliant results obtained with sofosbuvir,an HCV NS5B polymerase inhibitor,as well as by the data from the phaseⅡandⅢstudies on the various combinations of second-generation NS3/4A inhibitors and NS5A and/or NS5B ***,a great deal of concern has emerged from the real world scenario in which patients are often older and have more comorbidities than patients in theworld of trials.Furthermore,many of them have advanced fibrosis and previous failure with peginterferon and ribavirin *** data from the recent literature suggest that the host metabolic factors may play a minor but non-negligible role in these difficult-to-treat patients,an issue that will hopefully be investigated in further *** editorial aims to provide a detailed analysis of the role that host metabolic factors played in the past and what role they may play in the era of direct antiviral agents.
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