达诺瑞韦联合拉维达韦治疗慢性丙型肝炎患者疗效研究

Antiviral efficacy of danoprevir and ravidasvir combination in treating patients with chronic hepatitis C

目的观察应用达诺瑞韦联合拉维达韦治疗慢性丙型肝炎(CHC)患者的疗效。方法2021年1月~2023年1月我院收治的CHC患者84例,被分为对照组42例和观察组42例,分别给予聚乙二醇干扰素-α2b联合利巴韦林治疗12 w或给予达诺瑞韦联合拉维达韦治疗12 w,停药后随访24 w。使用全自动病毒载量分析系统检测血清HCV RNA载量,记录快速病毒学应答(RVR)、治疗结束时病毒学应答(ETVR)、持续病毒学应答(SVR12)和复发率。采用ELISA法检测血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)和IL-10水平。结果观察组RVR、ETVR和SVR12分别为64.2%、100.0%和100.0%,均显著高于对照组的42.8%、69.0%和54.8%(P<0.05);在治疗结束24 w时,观察组无病情复发病例(0.0%),而对照组复发6例(14.2%,P<0.05);在治疗结束时,观察组血清ALT和AST水平分别为(32.5±8.4)U/L和(33.8±8.6)U/L,均显著低于对照组【分别为(54.2±8.7)U/L和(53.5±7.1)U/L,P<0.05】;观察组外周血WBC和PLT计数及Hb水平分别为(5.6±0.7)×10^(9)/L、(108.1±18.9)×10^(9)/L和(113.7±16.2)g/L,均显著高于对照组【分别为(3.5±0.6)×10^(9)/L、(82.5±16.7)×10^(9)/L和(96.8±13.9)g/L,P<0.05】;观察组血清TNF-α、IL-6和IL-10水平分别为(5.4±0.4)ng/L、(15.6±3.7)ng/L和(64.3±12.7)ng/L,均显著低于对照组【分别为(9.0±0.5)ng/L、(22.9±4.0)ng/L和(125.4±24.3)ng/L,P<0.05】;在治疗期间,观察组不良反应发生率为14.2%,显著低于对照组的33.3%(P<0.05)。结论应用达诺瑞韦联合拉维达韦治疗CHC患者能较快地清除病毒,抗病毒治疗疗效好,近期复发率低。

Objective The aim of this study was to investigate the antiviral efficacy of danoprevir and ravidasvir in the treatment of patients with chronic hepatitis C(CHC).Methods 84 patients with CHC were enrolled in our hospital between January 2021 and January 2023,and were divided into control and observation group,with 42 cases in each group,receiving pegylated interferon-α2b and ribavirin combination,or danoprevir and ravidasvir combination antiviral therapy for 12 w.All patients were followed-up for 24 weeks after discontinuation of the regimen.Serum HCV RNA load was measured by using fully automated viral load analysis system,and the rapidvirological response(RVR),end-treatment virological response(ETVR)and sustained virological responseat 12 weeks(SVR12)were recorded.Serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and IL-10 levelswere assayed by ELISA.Results TheRVR,ETVR and SVR12 in the observation group were 64.2%,100.0%and 100.0%,all significantly higher than 42.8%,69.0%and 54.8%(P<0.05)in the control;24 weeks after discontinuation of the antiviral treatment,six patients(14.2%)in the control,but no patients(0.0%)in the observation relapsed(P<0.05);serum alanine aminotransferase and aspartate aminotransferase levels in the observation group were(32.5±8.4)U/L and(33.8±8.6)U/L,both significantly lower than[(54.2±8.7)U/L and(53.5±7.1)U/L,respectively,P<0.05]in the control;the while blood cell count,platelet count and hemoglobin concentration in the observation were(5.6±0.7)×10^(9)/L,(108.1±18.9)×10^(9)/L and(113.7±16.2)g/L,all significantly higher than[(3.5±0.6)×10^(9)/L,(82.5±16.7)×10^(9)/L and(96.8±13.9)g/L,respectively,P<0.05]in the control;serum TNF-α,IL-6 and IL-10 levels were(5.4±0.4)ng/L,(15.6±3.7)ng/L and(64.3±12.7)ng/L,all much lower than[(9.0±0.5)ng/L,(22.9±4.0)ng/L and(125.4±24.3)ng/L,respectively,P<0.05]in the control;during the antiviral treatment period,the incidence of untoward effects in the observation group was much lower than in the control(14.2%vs.33.3%,P<0.05).Conclusion The combination of danoprevir and ravidasvir in the treatment of patients with CHC could quickly clear the viremia,has a promising antiviral efficacy,and warrants further clinical investigation.