泛基因型DAA治疗慢性丙型肝炎

Pan-genotype DAA for treatment of chronic hepatitis C

目的观察泛基因型DAA(sofosbuvir+velpatasvir)治疗慢性丙型肝炎的疗效及副作用。方法在患者知情同意的情况下,选择符合条件(符合抗病毒治疗条件的我院2015-2017年间的住院或门诊丙型肝炎患者)的患者46人为治疗组,选择同期46例干扰素治疗的慢性丙型肝炎患者为对照组,治疗组采用泛基因型DAA治疗,12周后停药,对照组采用短效干扰素联合利巴韦林治疗。对比观察他们的治疗效果和副作用,疗效比较采用χ2检验。结果治疗组与对照组于12周时HCV-RNA转阴率,分别为93.47%和50%,两组对比差异有统计学意义(χ2=115.565,P<0.001),治疗组副作用少于对照组;同时治疗组内,基因1、2、3、6型的HCV-RNA转阴率分别为100%、100%、83.33%、100%。结论泛基因型DAA治疗慢性丙型肝炎疗效好,初步观察除基因3型外,其他均为100%,且副作用少,有待更大样本量的随机临床试验证实。

Objective To observe the therapeutic efficacy and side effects of pan-genotype DAA(sofosbuvir+velpatasvir)in the treatment of chronic hepatitis C.Methods After the informed consent was obtained from the patients,46 cases of chronic hepatitis C that met our recruitment criteria and were inpatients or outpatients in our hospital from 2015 to 2017 were selected as the treatment group.Other 46 cases of chronic hepatitis C receiving interferon therapy were selected as the control group.The treatment group was treated with pan-genotype DAA for 12 weeks,while the control group received short-acting interferon combined with ribavirin.The therapeutic efficacy and side effects were then compared.The comparison of therapeutic efficacy ts was evaluated by Chi-square test.Results At week 12,the HCV-RNA negative rates of the treatment group and the control group were 93.47%and 50%,respectively,with the difference being statistically significant(χ2=115.565,P<0.001).The side effects of the treatment group were less than those of the control group.In the treatment group,the negative rates of HCV-RNA in gene type 1,2,3,6 were 100%,100%,77.78%,and 100%,respectively.Conclusion In the treatment of chronic hepatitis C,pan-genotype DAA has a favorable curative effect and less side effects,with the negative conversion rates being 100%except for genotype 3.However,its therapeutic efficacy needs further prove by large scale randomized trial.