索磷布韦联合维帕他韦在慢性HCV感染患者中的治疗效果

Treatment effect of sofosbuvir combined with velpatasvir on patients with hepatitis C viral infection

目的评估NS5B抑制剂索磷布韦(sofosbuvir,SOF)和NS5A抑制剂维帕他韦(velpatasvir,VEL)联合持续治疗慢性HCV感染患者12周后的安全性和有效性。方法选取我院收治的72例慢性HCV感染患者为研究对象,采用SOF/VEL片剂的治疗方案,检测观察患者血清HCV RNA载量、肝功能检测包含AST、ALT、总胆红素(TBil)等,进行药物安全评估。结果慢性HCV感染患者治疗第4周和第12周后血清AST、ALT、TBil水平较治疗前均明显下降(P<0.05);APRI指数也在患者治疗的第4周和第12周明显下降(P<0.05)。抗病毒治疗2周后42例(57%)慢性HCV感染患者HCV RNA低于最低检测下限,在继续治疗4周、8周和12周时低于HCV RNA检测下限的患者分别达到64例(89%)、69例(96%)和70例(97%);疗程结束后12周,分别有18例(100%)2型、43例(96%)1b型、6例(75%)3型患者获得SVR。在治疗期间有46例(64%)患者出现不良反应,常见的为头痛、疲劳、恶心、咳嗽等轻微的不良反应。结论SOF/VEL用于慢性HCV感染患者1b、2a和3型均有效且均有较高的HCV RNA转阴率,早期疗效显著,不良反应发生率降低且均为轻微反应,临床用药安全性较高。

Objective To determine the efficacy and safety of NS5 B inhibitor sofosbuvir(SOF)combined with NS5 A inhibitor velpatasvir(VEL)in the treatment of patients with chronic hepatitis C virus infection(CHC).Methods A total of 72 CHC patients received SOF/VEL400/100 mg daily for 12 weeks,The patients were then tested for serum HCV RNA and liver function,including parameters of Alanine aminotransferase(ALT),Aspartate aminotransaminase(AST),total bilirubin(TBil).The safety of the medication was also evaluated.Results Serum AST,ALT and TBIL levels of the hepatitis C patients were significantly decreased after 4 and 12 weeks of SOF/VEL treatment(P<0.05).APRI index also significantly decreased at these time points(P<0.05).HCV RNA was below the detection limit in42 patients(57%)after2 weeks of antiviral treatment,and in 64(89%),69(96%)and 70 patients(97%)after 4,8 and 12 weeks of continued treatments,respectively.High sustained virologic response(SVR)rates were achieved in 18 patients with genotype 2 a(100%),43 patients with genotype 1 b(97%),and 6 patients with genotype 3(75%)at the end of 12 weeks’ treatment(SVR12).respectively.Adverse reactions were reported in 46(64%)patients during the treatment,which were most commonly headache,fatigue,nausea,cough and other mild symptoms.Conclusion SOF/VEL treatment is effective in patients with genotypes 1 b,2 a and 3 HCV infection.The medication also has significant early efficacy,low incidence and mild adverse reactions,and high clinical safety.