icon fsr

文献詳細

雑誌文献

medicina60巻1号

2023年01月発行

文献概要

特集 10年前の常識は非常識!?—イマドキ消化器診療にアップデート 疾患

B型肝炎,C型肝炎

著者: 長谷川泉1

所属機関: 1地域医療機能推進機構(JCHO)中京病院消化器内科

ページ範囲:P.127 - P.132

文献購入ページに移動
 B型肝炎,C型肝炎は肝炎ウイルス(hepatitis B virus:HBV,hepatitis C virus:HCV)による感染症である.慢性感染者では炎症は緩徐に進行し,高率に肝硬変や肝細胞癌(hepatocellular carcinoma:HCC)を発症する.HCCはわが国の死亡者数が第5位の癌である1).発癌の有無にかかわらず,いったん線維化が進行し肝機能が破綻すると,時に致命的ともなる肝疾患関連合併症を発症する.肝炎ウイルスを制御・駆除する目的は,こうした肝発癌および肝疾患関連死を抑止し患者のQOLを改善することにある.全世界で推定3億5,400万人がHBVまたはHCVに感染しているといわれ,WHOは2030年までにこれらの肝炎ウイルスの撲滅に向けての目標を設定・修正し,国単位で自国に即した目標を達成するよう勧告している2).本稿ではB型肝炎,C型肝炎について,治療の変遷および今後の展望について概説する.

参考文献

1)がん研究振興財団:がんの統計2022 https://ganjoho.jp/public/qa_links/report/statistics/pdf/cancer_statistics_2022.pdf(2022年9月閲覧)
2)World Health Organization:Hepatitis https://www.who.int/health-topics/hepatitis(2022年10月閲覧)
3)日本肝臓学会:B型肝炎治療ガイドライン第4版 https://www.jsh.or.jp/lib/files/medical/guidelines/jsh_guidlines/B_v4.pdf(2022年10月閲覧)
4)Ito K, et al:Predicting relapse after cessation of lamivudine monotherapy for chronic hepatitis B virus infection. Clin Infect Dis 38:490-495, 2004
5)Tenney DJ, et al:Long-term monitoring shows hepatitis B virus resistance to entecavir in nucleoside-naive patients is rare through 5 years of therapy. Hepatology 49:1503-1514, 2009
6)Seto WK, et al:Reduction of hepatitis B surface antigen levels and hepatitis B surface antigen seroclearance in chronic hepatitis B patients receiving 10 years of nucleoside analogue therapy. Hepatology 58:923-31, 2013
7)Murata K, et al:Induction of IFN-λ3 as an additional effect of nucleotide, not nucleoside, analogues;A new potential target for HBV infection. Gut 67:362-371, 2018
8)Chan H, et al:Improved bone and renal safety of switching from tenofovir disoproxil fumarate to tenofovir alafenamide;Preliminary results from 2 phase 3 studies in HBeAg-positive and HBeAg-negative patients with chronic hepatitis B. J Hepatol 66:S25, 2017
9)Umemura T, et al:Mortality secondary to fulminant hepatic failure in patients with prior resolution of hepatitis B virus infection in Japan. Clin Infect Dis 47:e52-56, 2008
10)Kusumoto S, et al:Monitoring of hepatitis B virus(HBV)DNA and risk of HBV reactivation in B-cell lymphoma;A prospective observational study. Clin Infect Dis 61:719-729, 2015
11)田中靖人:B型肝炎ウイルス治療-“臨床的治癒”から“機能的治癒”を目指して.日内会誌107:32-37, 2018
12)Yan H, et al:Sodium taurocholate cotransporting polypeptide is a functional receptor for human hepatitis B and D virus. Elife 1:e00049, 2012
13)Ni Y, et al:Hepatitis B and D viruses exploit sodium taurocholate co-transporting polypeptide for species-specific entry into hepatocytes. Gastroenterology 146:1070-1083, 2014
. Hepatology 74:83-98, 2021
15)Hepatitis B Foundation:Drug watch https://www.hepb.org/treatment-and-management/drug-watch/(2022年10月閲覧)
16)Choo Q, et al:Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 80:359-362, 1989
17)Smith, DB et al:Expanded classification of hepatitis C virus into 7 genotypes and 67 subtypes;Updated criteria and genotype assignment web resource. Hepatology Jan 59:318-327, 2014
18)日本肝臓学会:C型肝炎治療ガイドライン第1版.肝臓53:355-395, 2012
19)Tanaka Y, et al:Genome-wide association of IL28B with response to pegylated interferon-alpha and ribavirin therapy for chronic hepatitis C. Nat Genet 41:1105-1109, 2009
20)長谷川 泉,他:HCVの分子進化学.肝胆膵43:591-597, 2001
21)Lohmann V, et al:Replication of subgenomic hepatitis C virus RNAs in a hepatoma cell line. Science 285:110-113, 1999
22)Wakita T, et al:Production of infectious hepatitis C Virus in tissue culture from a cloned viral genome. Nat Med 11:791-796, 2005
23)Kumada H, et al:Daclatasvir plus asunaprevir for chronic HCV genotype 1b infection. Hepatology 59:2083-2091, 2014
24)Kosaka K, et al:Emergence of resistant variants detected by ultra-deep sequencing after asunaprevir and daclatasvir combination therapy in patients infected with hepatitis C virus genotype 1. J Viral Hepat 22:158-165, 2015
25)Mizokami M, et al:Ledipasvir and sofosbuvir fixed-dose combination with and without ribavirin for 12 weeks in treatment-naive and previously treated Japanese patients with genotype 1 hepatitis C;An open-label, randomised, phase 3 trial. Lancet Infect Dis 15:645-653, 2015
26)Chayama K, et al:Efficacy and safety of glecaprevir/pibrentasvir in Japanese patients with chronic genotype 1 hepatitis C virus infection with and without cirrhosis. J Gastroenterol 53:557-565, 2018
27)Kumada H, et al:Efficacy and safety of glecaprevir/pibrentasvir in HCV-infected Japanese patients with prior DAA experience, severe renal impairment, or genotype 3 infection. J Gastroenterol 53:566-575, 2018
28)Izumi N, et al:Sofosbuvir-velpatasvir plus ribavirin in Japanese patients with genotype 1 or 2 hepatitis C who failed direct-acting antivirals. Hepatol Int 12:356-367, 2018
29)Takehara T, et al:Efficacy and safety of sofosbuvir-velpatasvir with or without ribavirin in HCV-infected Japanese patients with decompensated cirrhosis;An open-label phase 3 trial. J Gastroenterol 54:87-95, 2019
30)日本肝臓学会:C型肝炎治療ガイドライン第8.1版,2022 https://www.jsh.or.jp/lib/files/medical/guidelines/jsh_guidlines/C_v8.1.pdf(2022年9月閲覧)

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1189

印刷版ISSN:0025-7699

雑誌購入ページに移動
icon up
あなたは医療従事者ですか?