中国感染控制杂志2023年4月第22卷第4期Chin J1 nfect Control Vol22No4Apr2023·369-D01:10.12138/j.issm.1671-9638.20234037·专家论坛·慢性肾脏病合并丙型肝炎病毒感染诊断、治疗和预防的临床实践指南(2023年版)慢性肾脏病合并丙型肝炎病毒感染诊断、治疗和预防专家组[摘要]丙型肝炎病毒(HCV)感染在慢性肾脏病(CKD)患者中高发，CKD患者在抗HCV治疗方面具有特殊性，随着直接抗病毒药物(DAA)问世并广泛应用于临床，CKD患者合并HCV感染的预后获得极大改善，近年来HCV治疗领域进展迅速，多种DAA相继在国内获批上市。为此，我国肾脏病、感染病、肝病和感控专家在2019年发表的《慢性肾脏病合并丙型肝炎病毒感染诊断及治疗的专家共识》基础上，以国内外临床研究进展为依据，结合现阶段我国实际情况，更新形成了本指南，以期为CKD合并HCV感染患者的规范化诊治提供指导性建议，[关键词]丙型肝炎病毒：慢性肾脏病：诊断：治疗：预防：指南[中图分类号]R692512.63Clinical practice guideline for the diagnosis,treatment and prevention ofhepatitis C virus infection in patients with chronic kidney disease (2023)Expert group on the diagnosis,treatment and prevention of hepatitis C virus infection in pa-tients with chronic kidney disease[Abstract]Hepatitis C virus (HCV)infection is of high prevalence among patients with chronic kidney disease(CKD).There are many unique features in anti-HCV treatment of CKD patients.With the advent of direct-actingantiviral agents (DAAs)and their widely application in clinic practice,the prognosis of CKD patients with HCV in-fection has been greatly improved.In recent years,rapid progress has been made in HCV treatment,and manyDAAs have been approved for marketing in China.Therefore,based on The ex pert consensus for the diagnosis andtreatment of hepatitis C virus in fection in patients with chronic kidney disease published in 2019,combined withthe domestic and foreign progress of clinical research and the national situation in China at present,a panel ofexperts specialized in nephrology,infectious disease,hepatology and infection control have updated and issued thisguideline,to provide guidance for the standardized diagnosis and treatment of HCV infection in CKD patients[Key words]hepatitis C virus:chronic kidney disease:diagnosis:treatment:prevention:guideline慢性肾脏病(chronic kidney disease,CKD)是增加了HCV感染的风险。一旦感染HCV,长期慢性我国重要的公共健康问题，流行率约为10.8%，据感染可进一步导致肝硬化与肝癌，及时清除HCV的此推算，我国成人CKD患者约1.2亿)。根据肾小抗病毒治疗可阻止疾病进展并降低远期并发症发生球滤过率估算值(estimated glomerular filtration率。近年来，直接抗病毒药物(direct-acting antiviralrate,eGFR),CKD可分为1~5期)。CKD患者agent,DAA)问世并广泛应用于临床，泛基因型免疫功能低下，易受细菌、病毒和其他病原体感染，DAA方案在已知主要基因型和主要基因亚型的丙型肝炎病毒(hepatitis C virus,HCV)感染在HCV感染患者中都能达到90%以上的持续病毒学CKD人群中更为高发，血液透析等高危因素进一步应答(sustained virological response,SVR),并且安[收稿日期]2023-01-14[通信作者]梅长林E-mail:chlmei1954@126.com:张文宏E-mail:zhangwenhong@fudan.edu.cn
