三种DAAs方案治疗慢性丙型肝炎患者两年随访研究*

doi:10.3969/j.issn.1672-5069.2024.01.009

摘要/Abstract

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。

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

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.

Key words: Hepatitis C, Direct-acting antiviral agents, Sustained virological response, Therapy

王焱, 韩军, 杨美蓉. 三种DAAs方案治疗慢性丙型肝炎患者两年随访研究^*[J]. 实用肝脏病杂志, 2024, 27(1): 32-35.

Wang Yan, Han Jun, Yang Meirong. Twenty-four month follow-up for patients with chronic hepatitis C after sustained virological response to different DAAs treatment regimen[J]. Journal of Practical Hepatology, 2024, 27(1): 32-35.

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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

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