艾尔巴韦/格拉瑞韦治疗慢性丙型肝炎患者疗效初步观察

doi:10.3969/j.issn.1672-5069.2020.05.011

摘要/Abstract

摘要： 目的初步探讨应用艾尔巴韦/格拉瑞韦治疗慢性丙型肝炎(CHC)患者的疗效。方法 2017年3月~2018年3月仙桃市第一人民医院感染病科收治的CHC患者82例,被随机分为对照组41例和观察组41例,分别给予聚乙二醇干扰素-α联合利巴韦林治疗和艾尔巴韦/格拉瑞韦治疗,两组均连续治疗24周。采用RT- PCR法检测血清 HCV RNA,采用全基因序列测定法行病毒基因分型。比较两组早期病毒学应答(EVR)、治疗结束时病毒学应答(ETVR)和持续病毒学应答(SVR)。结果在治疗结束时,观察组血清丙氨酸氨基转移酶(ALT)水平为(47.9±19.7)U/L,显著低于对照组【(63.5±21.2)U/L,P<0.05】,天冬氨酸氨基转移酶(AST)水平为(55.5±22.3)U/L,显著低于对照组【(81.3±25.8)U/L,P<0.05】;观察组EVR、ETVR和SVR分别为48.8%、63.4%和70.7%,与对照组的41.5%、53.7%和65.8%比,无统计学差异(P>0.05);18例观察组非HCV Ⅰ型感染者EVR、ETVR和SVR分别为88.9%、94.4%和88.9%,显著高于同组23例HCV Ⅰ型感染者(分别为52.2%、60.9%和52.2%, P<0.05),而与对照组15例非HCV Ⅰ型感染者比,无统计学差异(分别为86.7%、93.3%和73.3%, P>0.05);观察组SVR₁₂为87.8%(36/41),显著高于对照组的73.2%(30/41,P<0.05)。结论应用直接抗病毒(DAA)药物艾尔巴韦/格拉瑞韦治疗CHC患者近期疗效达到,但远期疗效似优于标准治疗方案, 值得临床进一步验证。

关键词: 慢性丙型肝炎, 直接抗病毒药物, 艾尔巴韦/格拉瑞韦, 病毒学应答, 治疗 , ,

Abstract: Objective The aim of this study was to investigate the virological response to direct antiviral agents (DAA),erbavir/gragrevir treatment in patients with chronic hepatitis C (CHC). Methods 82 patients with CHC were recruited in this study between March 2017 and March 2018,and were randomly divided into control (n=41) and observation group (n=41). The patients in the control group were treated with peginterferon-α and ribavirin combination,and those in the observation group were given erbavir/gragrevir. The regimen in the two groups lasted for 24 weeks. Serum HCV RNA was detected by RT-PCR,and virologic genotypes were determined by direct sequencing. The efficacy was assessed by early virological response (EVR),end-of-treatment response (ETVR) and sustained virological response (SVR). Results At the end of the treatment,serum alanine aminotransaminase level in the observation group was (47.9±19.7)U/L,much lower than 【(63.5±21.2)U/L,P<0.05】, serum aspartate transaminase level was (55.5±22.3)U/L,significantly lower than 【(81.3±25.8)U/L,P<0.05】 in the control group; the EVR,ETVR and SVR in the DAA-treated group were 48.8%,63.4% and 70.7%,not significantly different as compared to 41.5%,53.7% and 65.8% in interferon-α-treated group (P>0.05); the EVR,ETVR and SVR in 18 patients with non-HCV genotypeⅠ infection receiving DAA were 88.9%,94.4% and 88.9%,significantly higher than 52.2%,60.9% and 52.2% ( P<0.05) in 23 patients with HCV typeⅠ infection,while they were not significantly different compared to 86.7%,93.3% and 73.3% in 15 patients receiving interferon-α treatment (P>0.05); the SVR₁₂ in DAA-treated patients was 87.8%(36/41),significantly higher than 73.2%(30/41,P<0.05) in patients receiving interferon-α treatment. Conclusion The elbavir/gragrevir,a new DAAs,administration in the treatment of patients with CHC have a good short-term efficacy,which warrants further multi-centre,randomized,and control study.

Key words: Hepatitis C, Direct antiviral agents, Erbavir/gravivir, Virological response, Therapy

周长雄, 于文虎, 金笛. 艾尔巴韦/格拉瑞韦治疗慢性丙型肝炎患者疗效初步观察[J]. 实用肝脏病杂志, 2020, 23(5): 646-649.

Zhou Changxiong,Yu Wenhu,Jin Di.. Virological response to erbavir/gragrevir treatment in patients with chronic hepatitis C[J]. Journal of Practical Hepatology, 2020, 23(5): 646-649.

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