三种DAAs方案治疗慢性丙型肝炎患者两年随访研究
Twenty-four month follow-up for patients with chronic hepatitis C after sustained virological response to different DAAs treatment regimen
王焱 1韩军 1杨美蓉1
作者信息
- 1. 214000 江苏省无锡市 江南大学附属无锡市第五人民医院感染病科
- 折叠
摘要
目的 分析不同直接抗病毒药物(DAAs)治疗慢性丙型肝炎(CHC)患者的疗效,随访观察两年结果.方法 2018 年1 月～2020 年12 月我院收治的CHC患者123 例,其中接受索磷布韦/维帕他韦(SOF/VEL)治疗52 例,接受艾尔巴韦/格拉瑞韦(EBR/GZR)治疗43 例,接受来迪派韦/索磷布韦(LDV/SOF)治疗 28 例,均连续治疗 12 w,随访 24 m.采用实时荧光定量RT-PCR法检测血清HCV RNA,比较不同方案治疗患者快速病毒学应答(RVR)、早期病毒学应答(EVR)、治疗结束时病毒学应答(ETVR)和持续病毒学应答(SVR)情况.结果 SOF/VEL、EBR/GZR和LDV/SOF治疗患者RVR分别为96.2%、93.0%和92.9%,EVR分别为98.1%、97.7%和96.4%,ETVR和SVR均为100.0%,组间疗效比较,差异均无统计学意义(均P>0.05);在治疗过程中,SOF/VEL、EBR/GZR和LDV/SOF治疗组出现恶心、乏力和头晕等不良反应发生率分别为13.5%、11.6%和21.4%,组间比较,差异无统计学意义(P>0.05);在三组获得SVR者,分别有45例、36 例和23 例完成2 年监测随访,结果均未发生病毒学复发和病情反复情况,也未出现肝癌发生.结论 由于我国CHC患者以GT1b基因型感染为主,应用SOF/VEL、EBR/GZR或LDV/SOF抗病毒治疗效果均好,较长期的观察病情无反复.
Abstract
Objective The aim of this study was to investigate the twenty-four month follow-up efficacy for patients with chronic hepatitis C(CHC)after sustained virological response(SVR)to different direct-acting antiviral agents(DAAs)treatment regimen.Methods 123 patients with CHC were enrolled in our hospital between January 2018 and December 2020,and were divided into three groups,receiving sofosbuvir/velpatasvir(SOF/VEL)in 52 cases,elbasvir/grazoprevir(EBR/GZR)in 43 cases,and ledipasvir/sofosbuvir(LDV/SOF)in 28 cases.The antiviral regimen lasted for 12 weeks and all patients were followed-up for 24 weeks.Serum HCV RNA loads were detected by real-time fluorescence quantitative RT-PCR.The rapid virological response(RVR),early virological response(EVR),end of treatment virological response(ETVR)and SVR were recorded in three groups.Results The RVR in SOF/VEL-,EBR/GZR-and LDV/SOF-treated patients were 96.2%,93.0%and 92.9%,the EVR were 98.1%,97.7%and 96.4%,the ETVR and SVR in all patients were 100.0%,not significantly different among the three groups(all P>0.05);during the treatment,the incidences of untoward effects,such as nausea,fatigue and dizziness,in the three groups were 13.5%,11.6%and 21.4%,not significant different among them(P>0.05);7,7 and 5 patients with SVR in the three groups lost,all other patients with SVR were followed-up for 24 months,and no relapse or liver cancer were found.Conclusion All the antiviral regimen,with different DAAs have good efficacy as HCV GT1b infection is common in China,and no relatively long-term relapse.
关键词
慢性丙型肝炎/直接抗病毒药物/持续病毒学应答/治疗Key words
Hepatitis C/Direct-acting antiviral agents/Sustained virological response/Therapy引用本文复制引用
基金项目
中国肝炎防治研究基金会天晴肝病研究基金资助项目(TQGB20210198)
出版年
2024
国家科技期刊平台
NSTL
万方数据