半量索非布韦联合达卡他韦治疗透析患者慢性丙型肝炎的疗效及安全性研究

Study on efficacy and safety of half-dose sofosbuvir and full dose daclatasvir in treatment of chronic hepatitis C in hemodialysis patients

目的观察并探讨半量索非布韦联合达卡他韦治疗透析患者慢性丙型肝炎的疗效及安全性。方法规律透析患者合并慢性丙型肝炎39例,其中丙肝基因型1型8例。给予索非布韦半量联合达卡他韦常规剂量在透析结束时服用,疗程24周。观察停药后12周HCV应答率并记录不良反应。结果治疗2周时HCV-RNA阴转率(<15 IU/ml)为28例(71.8%),停药后12周病毒学应答率为100%。无因不良反应停药或减量患者。ALT/AST在治疗后显著下降,16例患者出现了HGB降低,平均降低(14.3±17.4)g/L,其中2例降低50 g/L以上。结论半量索非布韦联合达卡他韦治疗透析患者慢性丙型肝炎具有良好的疗效及安全性。

Objective To evaluate the effectiveness and safety with half-dose sofosbuvir and full dose daclatasvir for hepatitis C in hemodialysis patients. Method A total of 39 patients on regular hemodialysis with positive HCV-RNA were included, and 8 patients were genotype 1. Half-dose sofosbuvir and full dose daclatasvir were used at the end of hemodialysis for 24 weeks. Sustained viral response at 12 weeks, biochemistry results and side effects were recorded. Results HCV-RNA decreased to below 15 IU/ml in 2 weeks in 28 patients. Rate of sustained viral response in 12 week was 100%.No patients stopped treatment or reduced dosage due to side effect. ALT and AST decreased significantly after treatment. Hemoglobin decreases were found in 16 patients with more than 50 g/L in 2 cases, and the average of hemoglobin decreases was(14.3±17.4) g/L. Conclusion Treatment of halfdose sofosbuvir and full dose daclatasvir was effective and safe for hepatitis C in hemodialysis patients.