HIV和HCV共感染患者基于含依非韦伦方案抗HIV下直接抗HCV治疗的疗效和安全性

Efficacy and safety of the direct-acting anti-HCV therapy based on efavirenz-containing regimen on HIV/HCV co-infected patients

目的评价人类免疫缺陷病毒(human immunodeficiency virus,HIV)和丙型肝炎病毒(hepatitis C virus,HCV)共感染患者基于含依非韦伦(Efavirenz,EFV)方案抗HIV下直接抗HCV治疗的疗效和安全性。方法选取2020年1月至2023年9月梧州市第三人民医院感染科收治的基于含EFV方案抗HIV下索磷布韦维帕他韦直接抗HCV治疗的HIV和HCV共感染患者21例,疗程12周,停药随访12周,分析患者基线特征,比较治疗前后白细胞、血红蛋白、血小板、肝肾功能,评估患者基于抗HIV情况下直接抗HCV治疗的疗效以及停药12周病毒持续应答率和安全性。结果21例HIV和HCV共感染的患者基于含EFV方案抗HIV下,接受索磷布韦维帕他韦抗HCV治疗12周,停药随访12周,HCV病毒应答率均达到100%。与治疗前比较,患者血清丙氨酸转氨酶和天冬氨酸转氨酶水平降低(P<0.01),白细胞、血小板、血肌酐差异无统计学意义(P>0.05)。结论HIV和HCV共感染患者基于含EFV方案抗HIV下直接抗HCV的疗效确切,未发现明显不良反应。

Objective To evaluate the efficacy and safety of the direct-acting anti-HCV therapy based on the efavirenz(EFV)-containing regimen in patients with co-infection of human immunodeficiency virus(HIV)and hepatitis C virus(HCV).Methods A total of 21 HIV/HCV co-infected patients treated with the direct-acting anti-HCV therapy using sofosbuvir/velpatasvir in the EFV-containing regimens for HIV from January 2020 to September 2023 in the Department of Infectious Diseases of the Third People's Hospital of Wuzhou were collected.The treatment duration was 12 weeks,followed by a 12-week follow-up period after cessation of treatment.Baseline characteristics of the patients were analyzed.Changes in white blood cells,hemoglobin,platelets,liver and kidney function before and after treatment were compared to evaluate the efficacy of direct anti-HCV therapy based on the anti-HIV condition,and the sustained virologic response rate and safety at 12 weeks after cessation of treatment.Results All 21 HIV/HCV co-infected patients achieved a 100%of HCV viral response rate after receiving sofosbuvir/velpatasvir treatment for 12 weeks and a 12-week follow-up period under EFV-containing regimens for HIV.Serum alanine transaminase(ALT)and aspartate transaminase(AST)levels of all patients were significantly lower than those before treatment(P<0.01),while there were no significant changes in white blood cells,platelets,serum creatinine compared to before treatment(P>0.05).Conclusion Direct-acting anti-HCV treatment under EFV-containing regimens for HIV in HIV/HCV co-infected patients is effective without significant toxic side effects.