C 型肝炎治療ガイドライン （第 3.4版）

1 C 2015 5 ** * * ** Corresponding author: 173-8605 2 11 1 Tel 03(3964)1211 Fax 03(3964)6627 Email 2012 5 1 2013 8 ALT U/l +Peg-IFN -2b+ 3 1 Peg-IFN (IFN) 2013 11 2 +Peg-IFN + 3 IFN B 2014 9 3 C C SVR C COI 4 HCV 2014 10 2 2014 12 +Peg-IFN -2b+ 3 HCV 2015 3

2 HCV 2015 5 2 DAA DAA C . 1-1 C 1 1-2 C 1 1-3 C 2 1-4 C 3 1-5 SVR 4 IFN 5 2-1 IFN 5 2-2 PEG IFN 5 2-3 IFN 6 2-4 IFN 7 2-5 7

3 2-6 Peg-IFN -2a Peg-IFN -2b 8 2-7 IFN 8 2-8 IFN 10 2-9 IFN 11 . 11 3-1 12 3-2 12 Direct Acting Antivirals (DAAs) 13 4-1 14 4-1 -1 14 4-1 -1 -1 14 4-1-1-2 16 4-1-1-3 2 17 4-1 -2 18 4-1 -3 20 4-1 -4 20 4-2 21 4-2 -1 21 4-2-1-1 22

4 4-2-1-2 24 4-2-1-3 25 4-2 -2 26 4-2 -3 26 4-2 -4 27 4-3 27 4-3-1 27 4-3-2 28 4-3-3 / 28 4-3-3-1 28 4-3-3-2 29 4-3-3-2-1 IFN 29 4-3-3-2-2 31 4-3-3-3 33 4-3-3-4 34 4-3-3-5 34 4-4 38 4-4 -1 38 4-4-1-1 38 4-4-1-2 40 4-4-1-3 40 4-4-2 40 4-4 -3 40 4-4-4

5 41 4-5 41 4-5-1 42 4-5-1-1 42 4-5-1-2 42 4-5-2 44 4-5 -3 46 4-5 -4 47 4-5-5 47 48 5-1 1 48 5-1- 1 48 5-1-2 50 5-1-3 52 5-1-4 53 5-1-4-1.

6 54 5-1-4-2. 56 5-1-4-2-1 IFN(+ ) 56 5-1-4-2-2. 56 5-1-4-2-3. 57 5-2 1 59 5-2-1 59 5-2-1-1. 1 59 5-2-1-2. 2 59 5-2-2 60 5-2-2-1. 1 60 5-2-2-2. 2 60 5-3 ALT 61 62 6-1 62 6-1- 1 Peg-IFN+ 63 6-1-2 / 64 6-1-3 / 65 6-1-4 1 66 6-1-5 1 68 6-2 69 6-3 69 70 7-1 UDCA 70 7-2

7 SNMC 70 7-3 70 71 72 COI 87 C 88 DAA 92 96 97 98 1 C Hepatitis C virus; HCV 1989 Choo 1) A B 90% HCV HCV 1 7000 150 200 HCV 30% 70% HCV HCV 2) 1-1 C C HCV HCV interferon; IFN HCV RNA 3) 4-7) IFN HCV-RNA sustained virological response.

8 SVR HCV 7-14) IFN DAAs direct acting antivirals HCV IFN IFN DAAs HCV Recommendation C HCV HCV IFN HCV RNA IFN DAA HCV IFN HCV 1-2 C 2 IFN 1986 Hoofnagle A B IFN 15) 1991 1992 C IFN IFN pegylated interferon; Peg-IFN (sustained virological response.

9 SVR) HCV 1 SVR 40 50% HCV 2011 11 1 1 +Peg-IFN+ 3 SVR 70% 16-20) 201 11 21-23) 1 +Peg-IFN + 3 SVR 90% 21) 2014 7 IFN DAA NS5A IFN IFN SVR 80 90% 24) IFN NS5A/NS5B DAAs (direct anti-viral agents) 3 C 1-3 C HCV ALT 7) ALT (ALT 30 U/l ) ( 15 / l ) C ALT 30 U/l 15 / l ALT 30 U/l 15 / l C 3 4-6) Recommendation ALT (ALT 30 U/l ) ( 15 / l )

10 C ALT 30 U/l 15 / l ALT 30 U/l 15 / l 1-4 C C C C 55 60 65 65 8) 66 F2 15 / l F3 12 / l ( ) 3