索磷布韦联合利巴韦林治疗慢性丙型肝炎的疗效

Sofosbuvir and ribavirin combined treatment in the patients infected with hepatitis C virus

目的评价索磷布韦(SOF)联合利巴韦林(RBV)治疗慢性丙型肝炎(CHC)患者的疗效和安全性。方法回顾性分析2017年12月至2019年7月广州市第八人民医院门诊诊治的30例接受SOF联合RBV治疗的CHC患者,疗程为12~24周,随访12~24周,观察其停药12周持续病毒学应答率(SVR12)。结果30例CHC患者治疗4、8、12、24周血清HCV RNA转阴率分别为86.7%(26/30)、100.0%(30/30)、100.0%(30/30)和100.0%(22/22);SVR12为96.7%(29/30),SVR24为100.0%(16/16)。6a型、1b型、2a型SVR12分别为100.0%(11/11)、88.9%(8/9)、100.0%(8/8)。停药12周时血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)复常率为100.0%(30/30)。治疗期间血HGB正常占93.3%(28/30),HGB下降2例;3例基线估算的肾小球滤过率(eGFR)<90 mL/(min·1.73 m^2)患者未调整SOF剂量并完成疗程;2例合并HBV感染患者在治疗期间出现HBV DNA上升,加用抗乙肝病毒药物后HBV DNA持续阴性;30例CHC患者中有20例同时合并其他疾病,占66.67%,治疗期间未发生药物与药物相互作用(DDI)。结论采用SOF联合RBV治疗CHC患者可获得极高的SVR12和生化学应答,且安全性良好。

Objective To evaluate the efficacy and safety of combined treatment of sofosbuvir(SOF)and ribavirin(RBV)on patients of chronic hepatitis C(CHC).Methods 30 CHC patients were analyzed retrospectively,who took combined treatment of SOF and RBV for 12-24 weeks and followed-up for 12-24 weeks.For these patients,sustained virological response(SVR)was observed at the 12-week follow-up after drug withdrawal.Results For these 30 patients,negative conversion of serum HCV RNA was respectively 86.7%(26/30),100.0%(30/30),100.0%(30/30)and 100.0%(22/22)at 4,8,12 and 24 weeks therapy;SVR12 was 96.7%(29/30)and SVR24 was 100.0%(16/16).For patients with genotype6 a,1 b and 2 a,SVR12 was respectively 100.0%(11/11),88.9%(8/9)and 100.0%(8/8).Alanine aminotransferase(ALT)and aspartate aminotransferase(AST)normalization rate was 100.0%(30/30)at the 12-week follow-up after drug withdrawal.During treatment serum HGB normalization rate was 93.3%(28/30);2 patients had HGB decreased;at baseline,3 patients whose estimated glomerular filtration rate(e GFR)less than 90 mL/(min·1.73 m^2)had completed the treatment without adjustment of SOF dosage;the serum HBV DNA level in 2 patients co-infected with HBV increased during treatment and the HBV DNA was negative after antiviral treatment for hepatitis B virus.20 cases accounted for 66.67%in 30 patients,were received complicated drugs with others diseases;no drug-drug interaction(DDI)occurred during their treatment.Conclusion CHC patients who took SOF and RBV combined treatment could have very high SVR12 and biochemical response,and the therapy was also safe.