艾尔巴韦/格拉瑞韦治疗慢性肾病合并慢性丙型肝炎患者疗效和安全性研究*

doi:10.3969/j.issn.1672-5069.2025.06.006

摘要/Abstract

摘要： 目的观察艾尔巴韦/格拉瑞韦治疗慢性肾病合并慢性丙型肝炎(CHC)患者的疗效和安全性。方法 2018年2月～2023年11月我院诊治的正在接受血液透析治疗的慢性肾病合并CHC患者56例,给予艾尔巴韦/格拉瑞韦连续治疗12周。使用7500型实时荧光定量PCR仪定量检测血清HCV RNA载量,考核快速病毒学应答(RVR)、治疗结束病毒学应答(ETVR)和停药6月持续病毒学应答(SVR)。结果本组56例慢性肾病合并CHC患者感染病毒1b型11例(19.6%),2a型39例(69.6%)和1b/2a型6例(10.7%);治疗后,RVR、ETVR和SVR获得率分别为73.2%、91.1%和85.7%;血清ALT、AST、HCV RNA、BUN和sCr水平分别为30.6(29.7,37.5)U/L、 32.7(18.7,36.4)U/L、0.8(0.4,3.1)lg cps/ml、(7.8±1.8)mmol/L和132.7(85.7,262.4)μmol/L,均显著低于治疗前【分别为50.5(40.4,717.3)U/L、41.2(29.6,659.7)U/L、6.3(3.6,7.9)lg cps/ml、(11.3±2.4)mmol/L和261.5(174.6,349.1)μmol/L,P<0.05】;在艾尔巴韦/格拉瑞韦治疗过程中,共出现8种药物相关不良反应,如恶心、疲乏、高钾血症、厌食、便秘、血细胞减少、脱发和关节痛等,均未影响治疗。结论应用艾尔巴韦/格拉瑞韦治疗接受血液透析的慢性肾病合并CHC患者具有良好的疗效和安全性,值得扩大研究观察。

关键词: 慢性丙型肝炎, 艾尔巴韦, 格拉瑞韦, 慢性肾病, 治疗

Abstract: Objective The aim of this study was to investigate the safety and efficacy of elbavir/granavir antiviral regimen in the treatment of patients with chronic hepatitis C (CHC) and chronic renal disease (CRD). Methods 56 patients with CHC and CRD undergoing hemodialysis were admitted to our hospital between February 2018 and November 2023, and all received albavir/gravir antiviral treatment for 12 weeks. Serum HCV RNA loads were assayed by RT-PCR, and rapid virologic response (RVR), end treatment of virologic response (ETVR) and sustained virologic response (SVR) were recorded. Results Among 56 patients with CHC and CRD in our series, the infected genotypes of HCV included 1b in 11 cases(19.6%), 2a in 39 cases (69.6%) and 1b/2a in 6 cases (10.7%); the RVR, ETVR and SVR were 73.2%, 91.1% and 85.7%, respectively; by end of antiviral treatment, serum ALT, AST, HCV RNA loads, BUN and sCr levels were 30.6(29.7, 37.5)U/L, 32.7(18.7, 36.4)U/L, 0.8(0.4, 3.1)lg copies/ml, (7.8±1.8)mmol/L and 132.7(85.7, 262.4)μmol/L, all significantly lower than [50.5(40.4, 717.3)U/L, 41.2(29.6, 659.7)U/L, 6.3(3.6, 7.9)lg cps/ml, (11.3±2.4)mmol/L and 261.5(174.6, 349.1)μmol/L, respectively, P<0.05] at presentation; the adverse effects include nausea, fatigue, hyperkalemia, anorexia, constipation, hair loss and joint pains, and no discontinuation of antiviral treatment occurred in our series. Conclusion The albavir/gravir antiviral regimen in the treatment of patients with CHC and CRD is safe and efficacious, which warrants further clinical investigation.

Key words: Hepatitis C, Chronic renal disease, Albavir, Gravir, Therapy

蒋婵娟, 邵靖渊, 徐林. 艾尔巴韦/格拉瑞韦治疗慢性肾病合并慢性丙型肝炎患者疗效和安全性研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 822-825.

Jiang Chanjuan, Shao Jingyuan, Xu Lin. Efficacy and safety of albavir/gravir in the treatment of patients with chronic hepatitis C with underlying chronic renal disease[J]. Journal of Practical Hepatology, 2025, 28(6): 822-825.

参考文献

[1] Urban K, Payton C, Mamo B, et al. HepatitisC screening and antibody prevalence among newly arrived refugees to the United States, 2010-2017. J Immigr Minor Health, 2023, 25(6):1323-1330.
[2] Garcia-Crespo C, Francisco-Recuero I, Gallego I, et al. HepatitisC virus fitness can influence the extent of infection-mediated epigenetic modifications in the host cells. Front Cell Infect Microbiol, 2023, 13: 1057082.
[3] Nisingizwe MP, Makuza JD, Janjua NZ, et al. The cascade of care for hepatitisC treatment in Rwanda: a retrospective cohort study of the 2017-2019 mass screening and treatment campaign. Viruses, 2023, 15(3):633.
[4] Mei X, Zou J, Shi B, et al. High-resolution genomic profiling of a genotype 3b hepatitisC virus from a flare of an occult hepatitis patient with acute-on-chronic liver failure. Viruses, 2023, 15(3):634.
[5] Hutchison K, Page A, Hayward S. Everyone in: hepatitisC screening for rough sleepers accommodated during the covid-19 pandemic in Somerset, England. Frontline Gastroenterol, 2022, 13(4): 359.
[6] Fanizza FA, Loucks J, Berni A, et al. Patient access to hepatitisC treatment after incorporation of pharmacists in a hepatology clinic. Hosp Pharm, 2022, 57(3): 370-376.
[7] 中华医学会肝病学分会和感染病学分会.《丙型肝炎防治指南》2019年更新版.实用肝脏病杂志,2020,23(1):S33-52.
[8] 中华医学会肝病学分会,中华医学会感染病学分会.丙型肝炎防治指南(2022年版).中华肝脏病杂志,2022,30(12):1332-1348.
[9] Mani H, Yen JH, Hsu HJ, et al. HepatitisC virus core protein: not just a nucleocapsid building block, but an immunity and inflammation modulator. Tzu Chi Med J, 2022, 34(2): 139-147.
[10] Kherghehpoush S, McKeirnan KC. Pharmacist-ledHIV and hepatitis C point-of-care testing and risk mitigation counseling in individuals experiencing homelessness. Explor Res Clin Soc Pharm, 2021, 1: 100007.
[11] Coco LT, Silva GF, Romeiro FG, et al. Factors associated with hepatitisC treatment adherence: an integrative review. Cien Saude Colet, 2022, 27(4): 1359-1376.
[12] Jakhar N, Gera A, Mittal R, et al. Treatment of hepatitisC in a case of pediatric B-cell acute leukemia. J Glob Infect Dis, 2022, 14(1): 35-37.
[13] Strohbehn IA, Seethapathy R, Lee M, et al. Curative therapies for hepatitisC virus infection in patients with kidney disease. Kidney 360, 2021, 2(8): 1316-1325.
[14] Wolpert Barraza E, Kershenobich Stalnikowitz D, Guerrero Guerrero JE, et al. Micro-elimination of hepatitisC in low- and middle-income settings: challenges and windows of opportunity. Clin Liver Dis (Hoboken), 2022, 19(2): 38-40.
[15] Stan IS, Biciusca V, Durand P, et al. Diagnostic and prognostic significance of hepatic steatosis in patients with chronic hepatitis c. Rom J Morphol Embryol, 2021, 62(3): 765-775.
[16] Lee Wilkinson A, Pedrana A, Traeger MW, et al. Real-world monitoring progress towards the elimination of hepatitisC virus in australia using sentinel surveillance of primary care clinics; an ecological study of hepatitis C virus antibody tests from 2009 to 2019. Epidemiol Infect, 2021, 150: e7.
[17] Mir SA, Alshehri B. Seroprevalence of hepatitisB and C viral infections in the premarital adult population of al Majmaah, Saudi Arabia. Malawi Med J, 2021, 33(3): 221-225.
[18] Sonderup MW, Horak J, Smuts H, et al. Expanding the epidemiological understanding of hepatitisC in South Africa: perspectives from a patient cohort in a rural town. S Afr Med J, 2021, 111(8): 783-788.
[19] Galli A, Fahnoe U, Bukh J. High recombination rate of hepatitisC virus revealed by a green fluorescent protein reconstitution cell system. Virus Evol, 2022, 8(1): veab106.
[20] Martinello M, Solomon SS, Terrault NA, et al.Hepatitis C. Lancet, 2023, 402(10407):1085-1096.

艾尔巴韦/格拉瑞韦治疗慢性肾病合并慢性丙型肝炎患者疗效和安全性研究^*

Efficacy and safety of albavir/gravir in the treatment of patients with chronic hepatitis C with underlying chronic renal disease

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	姚羽, 宁波. 肝硬化门静脉血栓形成机制、自发性再通和抗凝治疗研究进展^*[J]. 实用肝脏病杂志, 2025, 28(6): 801-804.
[2]	李思思, 姜艳贞, 付兆媛. 中西医结合治疗肝纤维化研究进展与思考^*[J]. 实用肝脏病杂志, 2025, 28(6): 805-808.
[3]	华琪, 刘琼, 陈琦. 艾米替诺福韦治疗经恩替卡韦治疗的低病毒血症的慢性乙型肝炎患者疗效研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 818-821.
[4]	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.
[5]	李卉, 陶娅, 胥勋梅, 王金帆. 利拉鲁肽治疗NAFLD合并T2DM患者疗效及其对外周血单个核细胞NLRP3、Caspase-1和ASC水平的影响^*[J]. 实用肝脏病杂志, 2025, 28(6): 830-833.
[6]	郑慧慧, 王玉蓉, 徐婷. 血脂康联合阿托伐他汀治疗非酒精性脂肪性肝病合并高脂血症患者效果研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 834-837.
[7]	王美玲, 李洁, 刘娟, 孙婷婷. 司美格鲁肽联合非诺贝特治疗2型糖尿病合并非酒精性脂肪性肝病患者疗效初步研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 838-841.
[8]	高海娜, 梁盼, 高琳辉, 朱立影, 宋媛, 李印肖, 刘阳. 艾塞那肽联合二甲双胍治疗非酒精性脂肪性肝病合并2型糖尿病患者疗效初步研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 842-845.
[9]	陈晓玲, 张盼盼, 付玉芳, 王静. 司美格鲁肽联合化痰祛瘀通络方治疗NAFLD合并T2DM患者临床疗效初步研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 846-849.
[10]	田巍巍, 孙佳琦, 陈恳, 黄亚彬, 李锋, 冯海娟. 标准免疫抑制疗法联合甘草酸二铵治疗自身免疫性肝炎患者疗效研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 854-857.
[11]	黄晓黎, 沈杰. 恩替卡韦联合红外肝病治疗仪治疗乙型肝炎肝硬化患者疗效研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 878-881.
[12]	杨兰, 许诗杰, 包华鑫. 肝细胞癌患者TACE术后血清FGFR1、VEGFA和IRX5水平变化及其与疗效的关系研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 890-893.
[13]	李建林, 李娅, 郑秋然, 王燕. ¹²⁵I放射性粒子植入联合TACE治疗原发性肝癌患者疗效研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 894-897.
[14]	田潭平, 杨定华, 宋新, 周旅, 周国超, 付华, 蔡融民, 彭鹏. TACE联合免疫和靶向综合治疗中晚期原发性肝癌患者临床效果研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 898-901.
[15]	郭健伟, 贾健峰, 阳春, 刘娜, 曾勇, 李齐刚. 多模态超声评估原发性肝癌微血管侵犯及对经肝动脉栓塞化疗治疗后肿瘤复发的影响^*[J]. 实用肝脏病杂志, 2025, 28(6): 902-905.