Daclatasvir plus asunaprevir in treatment-na?ve patients with hepatitis C virus genotype 1b infection

AIM To assess daclatasvir plus asunaprevir(d UAL) in treatment-na?ve patients from China's Mainland, Russia and South Korea with hepatitis C virus(HCV) genotype 1 b infection. METHODS Patients were randomly assigned(3:1) to receive 24 wk of treatment with d UAL(daclatasvir 60 mg once daily and asunaprevir 100 mg twice daily) beginning on day 1 of the treatment period(immediate treatment arm) or following 12 wk of matching placebo(placebodeferred treatment arm). The primary endpoint was a comparison of sustained virologic response at posttreatment week 12(SVR12) compared with the historical SVR rate for peg-interferon plus ribavirin(70%) among patients in the immediate treatment arm. The first 12 wk of the study were blinded. Safety was assessed in d UAL-treated patients compared with placebo patients during the first 12 wk(doubleblind phase), and during 24 wk of d UAL in both arms combined.RESULTS In total, 207 patients were randomly assigned to immediate(n = 155) or placebo-deferred(n = 52) treatment. Most patients were Asian(86%), female(59%) and aged < 65 years(90%). Among them, 13% had cirrhosis, 32% had IL28 B non-CC genotypes and 53% had baseline HCV RNA levels of ≥ 6 million IU/m L. Among patients in the immediate treatment arm, SVR12 was achieved by 92%(95% confidence interval: 87.2-96.0), which was significantly higher than the historical comparator rate(70%). SVR12 was largely unaffected by cirrhosis(89%), age ≥ 65 years(92%), male sex(90%), baseline HCV RNA ≥ 6 million(89%) or IL28 B non-CC genotypes(96%), although SVR12 was higher among patients without(96%) than among those with(53%) baseline NS5 A resistanceassociated polymorphisms(at L31 or Y93 H). during the double-blind phase, aminotransferase elevations were more common among placebo recipients than among patients receiving d UAL. during 24 wk of d UAL therapy(combined arms), the most common adverse events(≥ 10%) were elevated alanine aminotransferase and upper respiratory tract infection; emergent grade 3-4 laboratory abnormalities were infrequently observed, and all grade 3-4 aminotransferase abnormalities(alanine aminotransferase, n = 9; aspartate transaminase, n = 6) reversed within 8-11 d. Two patients discontinued d UAL treatment; one due to aminotransferase elevations, nausea, and jaundice and the other due to a fatal adverse event unrelated to treatment. There were no treatment-related deaths.CONCLUSION d UAL was well-tolerated during this phase 3 study, and SVR12 with d UAL treatment(92%) exceeded thehistorical SVR rate for peg-interferon plus ribavirin of 70%.

Phosphorus removal by adsorbent based on poly-aluminum chloride sludge

Phosphorus adsorption tests were carried out using poly-aluminum chloride sludge(PACS),which was collected from a water treatment plant in Nanjing.The amount of phosphorus adsorbed by PACS increased quickly within the first hour and reached equilibrium after about 48 h.The adsorption behavior of PACS for phosphorus is consistent with the Langmuir adsorption isotherm equation(R2>0.99)and parallel first-order kinetic equation(R2>0.98).With the increase of the PACS concentration,the adsorption capacity of PACS for phosphorus decreased,and the removal rate increased.The results of batch tests showed that the adsorption capacities of PACS for phosphorus ranged from 1.64 to 1.13 mg/g when the pH value varied from 4 to 10.However,the adsorption capacity of PACS was not evidently influenced by temperature.In comparison with the ion exchange resin,the adsorption capacity of PACS was barely inhibited by competitive ions,such as SO2
4,NO
3,and Cl
.The PACS surface after adsorption became smooth,and the vibration peaks of AleO and AleOH shifted.Both HCl and NaOH have a strong desorption effect on PACS after adsorption saturation,and with higher concentrations of HCl and NaOH,the desorption effect was stronger.Results of column adsorption experiments showed that with lower phosphorus and hydraulic loads,the adsorption column took longer to reach saturation.This indicated that PACS could be used as an efficient material for removal of phosphorus from water.This study provides a new treatment method with PACS.