直接抗病毒药物治疗丙型肝炎合并透析患者的临床应用

丙型肝炎病毒（HCV）感染在慢性肾功能不全患者中较常见，尤其是在进行透析的患者中，HCV感染较普通患者的风险极大增加，同时还会导致肝细胞癌及肝硬化的发病率明显升高。近年来直接抗病毒药物（DAAs）在慢性丙型肝炎的治疗中取得了较好的疗效及安全性，本文通过总结DAAs在丙型肝炎合并透析患者中的应用进展，发现对于基因1~6型HCV合并透析患者，推荐使用G/P方案；由于索磷布韦（SOF）经肾脏代谢，在重度肾损害人群中的血药浓度较高，因此SOF组合方案并不推荐用于丙型肝炎合并透析患者的治疗。

Clinical Application of Direct-acting Antivirals in Hepatitis C Patients

Hepatitis C virus （HCV） infection is common in patients with chronic renal insufficiency.In those with dialysis，the risk of HCV infection is even higher.Besides，the risks of HCV-related hepatocellular carcinoma and cirrhosis are also significantly increased.In recent years，direct-acting antivirals have achieved good efficacy and safety in the treatment of chronic hepatitis C.This paper aims to summarize the application progress of DAAs in patients with hepatitis C on dialysis，conludes that G/P regimen is recommended for patients with HCV on dialysis of genotype 1-6 and SOF is not recommended for patients with hepatitis C on dialysis because of the high blood concentration of SOF in people with severe renal impairment due to renal metabolism.