3D方案治疗初始治疗的基因1b型慢性丙型肝炎患者疗效研究*

doi:10.3969/j.issn.1672-5069.2025.06.007

摘要/Abstract

摘要： 目的探讨3D方案治疗初始治疗的基因1b型慢性丙型肝炎(CHC)患者的疗效。方法 2020年1月～2024年12月我院收治的初始治疗的基因1b型感染的CHC患者102例,均接受帕里瑞韦/利托那韦/奥比他韦和达塞布韦抗病毒治疗12周。常规检测血液、血生化和病毒学指标,使用Fibrotouch行肝脏受控衰减参数(CAP)和肝脏硬度检测(LSM)。结果 102例CHC患者基线血清HCV RNA载量为(6.2±0.7)lg copies/ml,在治疗2 w末、治疗4 w末、治疗8 w末、治疗12 w末、随访12 w末和随访24 w末时,其载量分别为(5.1±1.4)lg copies/ml、(3.7±0.9)lg copies/ml、(2.4±0.7)lg copies/ml、(1.1±0.3)lg copies/ml、(0.7±0.3)lg copies/ml和(0.7±0.3)lg copies/ml;治疗结束时病毒学应答率(VR)为96.1%,在随访12 w和24 w时,分别为93.1%和93.1%;本组CHC患者基线血清ALT和AST水平分别为(81.3±7.8)U/L和(58.7±6.4)U/L,在治疗4 w后,逐渐恢复正常;基线外周血白细胞计数、血小板计数、LSM和CAP分别为(6.8±1.3)×10⁹/L、(205.4±47.1)×10⁹/L、(8.9±0.6)kPa和(255.4±8.9)dB/m,在治疗结束时分别为(6.7±1.1)×10⁹/L、(213.7±52.9)×10⁹/L、(8.5±0.5)kPa和(253.7±10.1)dB/m,在随访24 w时分别为(6.9±1.1)×10⁹/L、(215.8±54.3)×10⁹/L、(8.1±0.4)kPa和(256.9±8.4)dB/m,除随访24 w时LSM轻度下降(P<0.05)外,均无显著差异(P>0.05)。结论应用3D方案治疗初始治疗的基因1b型CHC患者近期疗效显著,且安全性良好,需要长期随访观察。

关键词: 丙型肝炎, 基因1b型, 帕里瑞韦/利托那韦/奥比他韦/达塞布韦, 病毒学应答, 不良反应, 治疗

Abstract: Objective The aim of this study was to investigate the antiviral efficacy of 3D regimen in the treatment of patients with naïve genotype 1b-infected chronic hepatitis C (CHC). Methods A total of 102 patients with genotype 1b-infeced CHC were enrolled in our hospital between January 2020 and December 2024, and all the naïve patients received paritaprevir, ritonavir, ombitasvir and dasabuvir combination antiviral therapy for 12 weeks. Blood, biochemical and virological parameters were routinely detected. Controlled attenuation parameter(CAP) and liver stiffness measurement (LSM) were detected by Fibrotouch. Results Serum HCV RNA load at baseline in the 102 patients with CHC was(6.2±0.7)lg copies/ml, and by end of 2 week, 4 week, 8 week, 12 week of antiviral treatment, and 12 week and 24 week of follow-up, it decreased to (5.1±1.4)lg copies/ml, (3.7±0.9)lg copies/ml, (2.4±0.7)lg copies/ml, (1.1±0.3)lg copies/ml, and (0.7±0.3)lg copies/ml and (0.7±0.3)lg copies/ml, respectively; the end-treatment virological response (VR) was 96.1%, and the sustained virological response (SVR) 12 and SVR 24 w were 93.1% and 93.1%, respectively; serum ALT and AST levels at presentation were (81.3±7.8)U/L and (58.7±6.4)U/L, and after four week antiviral treatment, they turned back to normal gradually; baseline peripheral white blood cell count, platelet count, LSM and CAP in the series were (6.8±1.3)×10⁹/L, (205.4±47.1)×10⁹/L, (8.9±0.6)kPa and (255.4±8.9)dB/m, by end of antiviral treatment, they were (6.7±1.1)×10⁹/L, (213.7±52.9)×10⁹/L, (8.5±0.5)kPa and (253.7±10.1)dB/m, and by end of 24 week follow-up, they changed to (6.9±1.1)×10⁹/L, (215.8±54.3)×10⁹/L, (8.1±0.4)kPa and (256.9±8.4)dB/m, respectively, apart from LSM decreased greatly (P<0.05) at end of 24 week follow-up, all without significant differences (P>0.05). Conclusion Short-term antiviral efficacy of 3D regimen is satisfactory and safe in patients with naïve genotype 1b-infected CHC, which needs long-term clinical observation.

Key words: Hepatitis C, Genotype 1b, Paritaprevir/ritonavir/ombitasvir/ dasabuvir, Virologic response, Adverse reaction, Therapy

王超杰, 谢群, 姜海, 周宝勤, 杨亮. 3D方案治疗初始治疗的基因1b型慢性丙型肝炎患者疗效研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 826-829.

Wang Chaojie, Xie Qun, Jiang Hai, et al. Antiviral efficacy of 3D regimen in the treatment of patients with naïve genotype 1b-infected chronic hepatitis C[J]. Journal of Practical Hepatology, 2025, 28(6): 826-829.

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3D方案治疗初始治疗的基因1b型慢性丙型肝炎患者疗效研究^*

Antiviral efficacy of 3D regimen in the treatment of patients with naïve genotype 1b-infected chronic hepatitis C

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