对于第一代蛋白酶抑制剂治疗失败的肝硬化患者，使用达卡他韦和索磷布韦治疗24周，不联用利巴韦林。
Treatment with daclatasvir and sofosbuvir for 24 weeks without ribavirin in cirrhotic patients who failed first-generation protease inhibitors.
作者信息
Boglione Lucio, Pinna Simone Mornese, Cardellino Chiara Simona, De Nicolò Amedeo, Cusato Jessica, Carcieri Chiara, Cariti Giuseppe, Di Perri Giovanni, D'Avolio Antonio
机构信息
Unit of Infectious Diseases, University of Turin, Turin, Italy.
Department of Medical Sciences, Amedeo di Savoia Hospital, C.so Svizzera 164, 10149, Turin, Italy.
出版信息
Infection. 2017 Feb;45(1):103-106. doi: 10.1007/s15010-016-0962-3. Epub 2016 Nov 16.
BACKGROUND
Treatment of patients with chronic hepatitis C who failed the triple therapy with first generation of protease inhibitors is not still defined. The combined use of sofosbuvir (SOF) and daclatasvir (DCV) seems to be promising due to higher genetic barrier, good tolerance and effectiveness.
METHODS
We described the treatment with this drug combination in a real-life cohort of 20 cirrhotic patients with genotype 1 who failed the triple therapy.
RESULTS
18 of them (90%) with Child-Pugh A, 11 (55%) with genotype 1a, 17 (85%) with more than 1 and 8 (40%) with more than 2 previous failed treatment; all patients had at baseline NS3 resistance-associated variants related to triple therapy failure. RBV was not administered due to anemia in previous treatments. The sustained virological response was 100%.
CONCLUSION
Treatment with SOF + DCV without RBV for 24 weeks is safe and effective in cirrhotic patients who failed triple therapy with the first generation of protease inhibitors.
背景
对于接受第一代蛋白酶抑制剂三联疗法治疗失败的慢性丙型肝炎患者，其治疗方案仍未明确。由于较高的基因屏障、良好的耐受性和有效性，索磷布韦（SOF）和达卡他韦（DCV）联合使用似乎很有前景。
方法
我们描述了在20例接受三联疗法治疗失败的1型肝硬化患者的真实队列中使用这种药物组合进行治疗的情况。
结果
其中18例（90%）为Child-Pugh A级，11例（55%）为1a基因型，17例（85%）有超过1次既往治疗失败，8例（40%）有超过2次既往治疗失败；所有患者基线时均存在与三联疗法失败相关的NS3耐药相关变异。由于既往治疗中出现贫血，未给予利巴韦林（RBV）。持续病毒学应答率为100%。
结论
对于接受第一代蛋白酶抑制剂三联疗法治疗失败的肝硬化患者，使用SOF + DCV且不使用RBV进行24周治疗是安全有效的。
Zotero 插件