藥癮者及愛滋感染者的C型肝炎感染現況與治療

Current Status and Treatment of Hepatitis C Infection in People Who Inject Drugs and HIV-Infected Patients

蘇培元(Pei-yuan Su) ； 蘇維文(Wei-Wen Su) ； 陳昶華(Chang-Hua Chen)

《感染控制雜誌》 30卷4期 (2020/08) Pp. 239-248

https://doi.org/10.6526/ICJ.202008_30(4).0003

摘要

近幾年C型肝炎的治療有著非常突破性的進展，新型口服抗病毒藥物（Direct antiviral agent, DAA）不僅療效優異、且副作用低。C型肝炎感染中有兩個特殊族群：藥癮者與愛滋感染者，這兩個族群的傳染途徑因經由靜脈注射毒品而有些重疊，C肝基因型的分布因此有著類似的地方，除常見的1,2型外，3,6型是這兩個族群的特點，因此治療藥物的選擇也有類似之處。本文先探討國外有關這兩大特殊族群合併C型肝炎的流行病學近況，接著加入近幾年本土先進們的研究成果，再介紹DAA治療的臨床試驗結果與實際臨床成效。Reinfection在這兩個特殊族群也是偏高，可能是經由再次注射毒品或性行為傳染，積極治療C型肝炎與結合安全針具與安全性行為是降低再感染的首選方法。

關鍵字

藥癮 ； 愛滋 ； C型肝炎

並列摘要

In recent years, there has been a great breakthrough in the treatment of hepatitis C. The novel direct antiviral agent (DAA) has not only excellent efficacy but also few side effects. There are two special groups of patients with hepatitis C infection: people who inject drugs and HIV-infected patients. Administered with intravenous injection of drugs, both groups have the same transmission routes and thus similar hepatitis C genotypes. Besides the common genotypes (types 1 and 2), types 3 and 6 are characteristic in these two groups, and hence their drugs are similar. This study discusses the current prevalence status of hepatitis C between these two special populations in foreign countries, presents research accomplishments of domestic pioneers in recent years, and introduces clinical trial results and the actual clinical efficacy of DAA treatment. Reinfection is also higher in these two special groups, which may be transmitted by reinjection of drugs or sexual behavior. Active treatment of hepatitis C combined with safety needle and safe sexual behavior are the first line to reduce reinfection.

並列關鍵字

People who inject drugs ； HIV ； HCV