以索磷布韦为基础的DAA治疗泛基因型慢性丙型肝炎患者的疗效观察

The efficacy of sofosbuvir-based DAAs treatment on chronic hepatitis C patients with pan-genotypic hepatitis C viral infection

目的评价以索磷布韦为基础的DAA治疗泛基因型慢性丙型肝炎患者的疗效。方法采用回顾性分析,收集2017年7月至2020年1月在新疆医科大学第四附属医院肝病科诊断为慢性丙型肝炎,并接受以索磷布韦为基础的DAA治疗方案且完成疗程的患者(均使用目前上市的DAA药物),治疗期间均采用高灵敏HCV RNA检测,观察抗病毒治疗的SVR率。结果共纳入患者134例,其中男性72例,女性62例;年龄<60岁95例,年龄≥60岁39例。汉族121例,少数民族13例;初治118例,经治16例;肝硬化59例,非肝硬化75例。基因型:1b型53例,2a型57例,3a型10例,3b型12例,6型1例,混合型(1b,2a)1例。基因1b型:索磷布韦/维帕他韦治疗23例,索磷布韦联合利巴韦林治疗16例,来迪派韦/索磷布韦治疗11例,索磷布韦联合达拉他韦治疗3例,疗程12周。基因2a型:索磷布韦/维帕他韦治疗32例,索磷布韦/维帕他韦片联合利巴韦林治疗5例,索磷布韦联合利巴韦林治疗20例,疗程12周。基因3型:索磷布韦/维帕他韦治疗16例,疗程12周;索磷布韦联合利巴韦林治疗6例,疗程12~24周。基因6型:索磷布韦联合利巴韦林治疗1例,疗程12周。混合型:索磷布韦/维帕他韦片1例,疗程12周。以索磷布韦为基础的DAA治疗慢性丙型病毒性肝炎患者均达到SVR。结论以索磷布韦为基础的DAA治疗泛基因型慢性丙型肝炎患者治愈率高,耐受性好。

Objective To evaluate the efficacy of sofosbuvir-based direct-acting antiviral agents(DAA)treatment on chronic hepatitis C patients with pan-genotypic hepatitis C viral infection.Methods A total of 134 Patients diagnosed with chronic hepatitis C in the Liver Diseases Branch of Fourth Affiliated Hospital of Xinjiang Medical University from July 2017 to January 2020 were collected and retrospectively analyzed.These patients received sofosbuvir-based DAAs and completed the recommended treatment course.They had been tested with highly sensitive hepatitis C RNA quantification method during the treatment to observe the sustained virological response(SVR)rate of antiviral treatment.Results Within the 134 patients,72 were males and 62 were females;95 patients were<60 years old,39 patients were≥60 years old;121 patients were Han nationality,13 patients were ethnic minorities;118 were treatment na ve patients,16 patients had previous treatment-experience;59 patients were cirrhotic and 75 were non-cirrhotic;For the infected HCV genotype(GT):53 patients were GT 1b,57 patients were GT 2a,10 patients were GT 3a,12 patients were GT 3b,1 patient was of GT 6,and 1 patient was mixed GTs 1b and 2a.For GT1b,23 patients were treated with sofosbuvir/velpatasvir,16 patients were treated with sofosbuvir plus ribavirin,11 patients were treated with ledipasvir/sofosbuvir and 3 patients were treated with sofosbuvir plus daclatasvir for 12 weeks.For GT 2a,32 patients were treated with sofosbuvir/velpatasvir,5 patients were treated with sofosbuvir/velpatasvir plus ribavirin and 20 patients were treated with sofosbuvir plus ribavirin for 12 weeks.For GT 3,16 patients were treated with sofosbuvir/velpatasvir for 12 weeks;6 patients were treated with sofosbuvir plus ribavirins for 12-24 weeks.For GT 6:1 patient was treated with sofosbuvir plus ribavirin tablets for 12 weeks.For mixed GTs(1b,2a):1 patient was treated with sofosbuvir/velpatasvir for 12 weeks.Sofosbuvir-based DAAs treatment of all patients with chronic hepatitis C reached SVR.Conclusion The Sofosbuvir-based DAAs treatment has a high overall SVR and well tolerance in chronic hepatitis C patients with pan-genotypic HCV infection.