Cho Byeong Wook, Kim Seok Bae, Song Il Han, Lee Sae Hwan, Kim Hong Soo, Lee Tae Hee, Kang Young Woo, Kim Seok Hyun, Lee Byung Seok, Chae Hee Bok
Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
Clin Mol Hepatol. 2017 Mar;23(1):51-56. doi: 10.3350/cmh.2016.0053. Epub 2017 Mar 16.
BACKGROUND/AIMS: The combination of daclatasvir (DCV) and asunaprevir (ASV) has demonstrated a high sustained virologic response at 12 weeks (SVR12) and a low rate of adverse events in previous clinical studies. The purpose of this study was to clarify the results of treatment and side effects in Korean patients with chronic hepatitis C virus (HCV) genotype Ib infection.
We retrospectively analyzed clinical data from chronic HCV genotype Ib patients treated with DCV+ASV from August 2015 to September 2016 at five hospitals in the Daejeon-Chungcheong area.
A total of 152 patients were examined for resistance associated variants (RAVs). Among them, 15 (9.9%) were positive for Y93 and one (0.7%) was positive for L31. Of 126 patients treated with DCV+ASV, 83 patients completed treatment and 76 patients were included in safety and efficacy analysis. Five (6.6%) were positive for Y93 and 12 (15.8%) exhibited cirrhotic change. DCV+ASV was the first-line treatment for 58 (76.3%) patients. Eleven (14.5%) patients relapsed after previous treatment that included interferon and seven (9.2%) of these patients were found to be intolerant of interferon. Adverse events occurred in 10 (13.2%) patients and two patients stopped the medication because of severe itching and skin rash. SVR12 was 89.5% (68/76) in all patients and 91.5% (65/71) in RAV-negative patients.
DCV+ASV showed good efficacy in patients with HCV Ib infection in Korea. Close monitoring is needed for severe adverse events and treatment failure, which were uncommon.
背景/目的:在先前的临床研究中,达卡他韦(DCV)与阿舒瑞韦(ASV)联合使用已显示出12周时较高的持续病毒学应答率(SVR12)以及较低的不良事件发生率。本研究的目的是阐明韩国慢性丙型肝炎病毒(HCV)1b型感染患者的治疗结果及副作用。
我们回顾性分析了2015年8月至2016年9月在大田 - 忠清地区五家医院接受DCV + ASV治疗的慢性HCV 1b型患者的临床资料。
共对152例患者进行了耐药相关变异(RAV)检测。其中,15例(9.9%)Y93呈阳性,1例(0.7%)L31呈阳性。在126例接受DCV + ASV治疗的患者中,83例完成治疗,76例纳入安全性和疗效分析。5例(6.6%)Y93呈阳性,12例(15.8%)出现肝硬化改变。DCV + ASV是58例(76.3%)患者的一线治疗方案。11例(14.5%)患者在先前包括干扰素的治疗后复发,其中7例(9.2%)患者被发现对干扰素不耐受。10例(13.2%)患者发生不良事件,2例患者因严重瘙痒和皮疹停药。所有患者的SVR12为89.5%(68/76),RAV阴性患者的SVR12为91.5%(65/71)。
DCV + ASV在韩国HCV 1b型感染患者中显示出良好疗效。对于严重不良事件和治疗失败需要密切监测,这些情况并不常见。