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<title>C型肝炎治療のためのDAAの使い方（電子版のみ） | 株式会社文光堂</title>


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<meta name="description" content="2014年以降，高い抗ウイルス効果を持つ直接作用型抗ウイルス薬（DAA）が次々と臨床に登場し，これまで主にインターフェロン（IFN）に頼っていたC型肝炎の治療は一変した．本書は，第1・2章ではC型肝炎診療とDAAの基本的な事項について解説し， 第3章では治療対象・治療方法の選択から，処方の実際，注意すべき副作用，耐性変異，薬剤相互作用，治療後のフォローアップまでの実践的な内容を解説．C型肝炎診療に">

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		<h1 class="catchCopy">C型肝炎治療のための直接作用型抗ウイルス薬（DAA）の使い方をこの１冊で極める！</h1>
		

		<h1 class="title titleWidth">C型肝炎治療のためのDAAの使い方（電子版のみ）<span class="version"></span></h1>
		

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					編集：田中　篤（帝京大学医学部内科学講座教授）
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				<ul class="property"><li class="disc">B5判・128頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1897-0</li><li class="disc">2016年10月21日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">2014年以降，高い抗ウイルス効果を持つ直接作用型抗ウイルス薬（DAA）が次々と臨床に登場し，これまで主にインターフェロン（IFN）に頼っていたC型肝炎の治療は一変した．本書は，第1・2章ではC型肝炎診療とDAAの基本的な事項について解説し， 第3章では治療対象・治療方法の選択から，処方の実際，注意すべき副作用，耐性変異，薬剤相互作用，治療後のフォローアップまでの実践的な内容を解説．C型肝炎診療に携わる肝臓内科医必読の１冊．</section><section class="preface">序<br><br>　C型肝炎ウイルスhepatitis Cvirus（HCV）に対する抗ウイルス治療の進歩は日進月歩である．はじめて直接作用型抗ウイルス薬direct acting antiviral（DAA）が世に出たのは2011年，わずか5年前のことであったが，その後2016年10月現在まで9種類のDAAが市販され，日常臨床に使用されるに至った．しかし，そのうちIFNと併用する，いわゆるIFN based治療に用いられるDAAは早くも日常臨床から消えつつあり，IFNを用いないIFN-free DAAが現在のC型肝炎治療の主流となっている．このような状況の中で，C型肝炎患者の診療に当たる私たち臨床家が，心に留めておくべきことは何だろうか．<br>　まず何よりも重要なのは，DAAを使ってHCVを確実に排除することである．現在使用できるDAAを手当たり次第に使ってみるというのではなく，最も適切なDAAを，最も適切な時期に処方して，安全かつ確実にHCVを排除すること．もし治療に成功しなかった場合には，次にいつ，どの薬剤で治療を行うべきか検討すること．そのためには，現在使用できる，あるいは今後使用可能となる各DAAの特性を踏まえ，個々の患者および感染しているHCVのウイルス学的状態を十分把握しておく必要がある．<br>　HCVの排除に次いで大切なのは，私たちの視野を，患者の肝臓に感染している小さなウイルスから患者全体へと移すことである．HCV治療の目的は，決してHCVの排除それ自体ではなく，HCVの排除によって肝疾患の進展を予防することであり，究極的には生命予後の延長およびQOLの改善にある，ということは，いくら強調してもし過ぎることはない．DAAという有効性・安全性の高い薬剤の登場によって，私たちははじめて，治療中のQOLをさほど低下させることなく，高い確率でHCVを排除することができるようになった．これは素晴らしいことである．しかし，IFN-free DAAによるHCVの排除が本当に肝癌の発症を抑制し生命予後を改善させているかどうかについて，私たちはまだ答えを得ていない．今後，HCVの排除に成功した患者を注意深く見つめていかなければならない．<br>　今回，以上のような問題意識からこの本を編んだ．国内のC 型肝炎治療のエキスパートの先生方にご執筆をお願いして，C型肝炎の診療に携わる私たち臨床家が知っておくべき知識を網羅したと自負している．多忙な日常臨床の中ご執筆くださった先生方にこの場を借りて深謝するとともに，この小さな書籍が，日本にまだまだ多数存在するC型肝炎患者，および日々増加し続けているHCVを排除した患者の幸せに，少しでも貢献することを願う．<br><br>平成28年10月<br>帝京大学医学部内科学講座教授<br>田中　篤</section><section class="indexes">第1章　C型肝炎診療の基本<br>　1　C型肝炎とは？ ─感染症ではなく肝疾患・全身疾患として─<br>　2　C型肝炎の診断<br>　3　C型肝炎の経過（自然史）<br>　4　C型肝炎の治療<br>第2章　DAAとは？<br>　1　DAAの種類と作用機序<br>　2　DAAの治療成績<br>第3章　DAAによるC型肝炎治療の実際<br>　1　治療対象・治療方法の選択<br>　2　DAA処方の実際<br>　　A　プロテアーゼ阻害薬を含む3剤併用療法<br>　　B　IFN-free療法<br>　　　① ダクラタスビル＋アスナプレビル併用療法<br>　　　② ソホスブビル＋リバビリン併用療法<br>　　　③ ソホスブビル/レジパスビル併用療法<br>　　　④ オムビタスビル/パリタプレビル/リトナビル併用療法<br>　3　副作用への対策<br>　4　耐性変異への対策<br>　5　薬物相互作用への注意<br>　6　治療後のフォローアップ<br>索引</section></article>
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