3D方案(帕里瑞韦/利托那韦/奥比他韦联合达塞布韦)治疗初治基因1b型慢性丙型肝炎患者的效果分析

Clinical effect of 3D regimen(paritaprevir/ritonavir/ombitasvir combined with dasabuvir) in treatment-naive patients with genotype 1b chronic hepatitis C

目的观察3D方案(帕里瑞韦/利托那韦/奥比他韦联合达塞布韦)治疗初治基因1b型慢性丙型肝炎患者的临床疗效。方法纳入2015年9月-2016年4月就诊于第四军医大学唐都医院传染科初治的基因1b型慢性丙型肝炎患者10例。给予3D方案治疗12周,治疗结束后随访24周,观察治疗结束后12周和24周持续病毒学应答(SVR12和SVR24)情况,并监测生化学变化和不良反应发生情况。计量资料多组间比较采用方差分析。结果治疗2周,70%患者HCV RNA达到检测下限以下;治疗12周,100%患者HCV RNA检测不到,生化学应答率达100%。SVR12和SVR24均为100%。治疗期间和随访24周患者ALT、AST和炎症性指标干扰素诱导蛋白10均较治疗前显著下降(F值分别为20.15、10.83、13.67,P值均<0.05)。主要不良反应包括乏力和头痛,无严重不良事件。结论对于初治的基因1b型慢性HCV感染者,经3D方案治疗可获得极高的SVR率以及生化学应答率,并可改善患者肝功能,且具有良好的安全性。

Objective To investigate the clinical effect of 3D regimen（paritaprevir/ritonavir/ombitasvir combined with dasabuvir） in treatment-naive patients with genotype 1b chronic hepatitis C. Methods A total of 10 patients with genotype 1b chronic hepatitis C who were treated for the first time in Department of Infectious Diseases in our hospital from September 2015 to April 2016 were enrolled. All patients were treated with 3D regimen for 12 weeks and followed up for 24 weeks after treatment. Sustained virologic response at 12 and 24 weeks（SVR12 and SVR24） was observed,and the changes in biochemical parameters and the incidence of adverse events were monitored. An analysis of variance was used for comparison of continuous data between groups. Results After 2 weeks of treatment,70% of all patients achieved an HCV RNA level reduced to below the detection level,and after 12 weeks of treatment,HCV RNA was not detected in any patient,resulting in a biochemical response rate of 100%. Both SVR12 and SVR24 were 100%. There were significant reductions in the levels of alanine aminotransferase,aspartate aminotransferase,and the inflammatory marker interferon-inducible protein 10 after treatment（F =20. 15,10. 83,and 13. 67,all P〈0. 05）. The most common adverse events were weakness and headache and no serious adverse events were observed. Conclusion In treatment-naive patients with genotype 1b chronic hepatitis C,3D regimen achieves high SVR rate and biochemical response rate,improves patients＇ liver function,and has good safety.