Sarwar Shahid, Khan Anwaar A
Dr. Shahid Sarwar, MBBS, FCPS (Med), FCPS (Gastroenterology), MCPS-HPE, Associate Professor of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan. Department of Gastroenterology, Doctors Hospital and Medical Center (DH&MC), Lahore, Pakistan.
Dr. Anwaar A. Khan, ABIM, ABIM (GE), MACP, FACG, FRCP, AGAF, FCPS. Ex-Dean and Chairman Shaikh Zayed Hospital, Consultant Gastroenterologist, Doctors Hospital and Medical Center, Department of Gastroenterology, Doctors Hospital and Medical Center (DH&MC), Lahore, Pakistan.
Pak J Med Sci. 2017 Jan-Feb;33(1):37-41. doi: 10.12669/pjms.331.12163.
To compare sustained viral response to sofosbuvir/ribavirin ±interferon therapy in patients of hepatitis C with and without liver cirrhosis.
This observational study of chronic hepatitis C patients was carried out at Doctors Hospital and Medical Center (DH&MC). After diagnostic workup, Sofosbuvir/ribavirin for 24 weeks or sofosbuvir/ribavirin/pegylated interferon for 12 weeks were prescribed. Primary outcome was negative HCV RNA by PCR 12 weeks after treatment completion (SVR). Chi square χ and student's t test were used to analyze data.
Of 216 patients included, liver cirrhosis was present in 112 (51.9%) patients and 69(31.9%) were treatment experienced. Liver disease was decompensated in 37 (17.1%) patients. Of 206 patient who completed study protocol, 173(83.1%) achieved SVR, 89.2% (25/28) with triple therapy and 82.2% (148/180) with sofosbuvir/ribavirin therapy. Treatment response was similar between treatment naïve 86.2% (119/138) and treatment experienced 79.4% (54/68) patents. (p value 0.19) SVR was inferior in cirrhosis patients 75.4% (80/106) as compared to those with no cirrhosis 93% (93/100) (p value < 0.000). It was even lesser in those with decompensated liver disease 68.8% (24/35) (p value < 0.000).
Treatment outcome with sofosbuvir/ribavirin combination therapy in cirrhosis patients is suboptimal especially in those with decompensation as compared to patients without liver cirrhosis.
比较丙型肝炎患者在使用和不使用干扰素的情况下，接受索磷布韦/利巴韦林治疗后的持续病毒学应答情况。
本观察性研究在多科医院及医疗中心（DH&MC）对慢性丙型肝炎患者开展。在完成诊断检查后，给予患者24周的索磷布韦/利巴韦林治疗或12周的索磷布韦/利巴韦林/聚乙二醇干扰素治疗。主要结局指标为治疗结束12周后通过聚合酶链反应检测丙型肝炎病毒核糖核酸（HCV RNA）呈阴性（持续病毒学应答，SVR）。采用卡方检验（χ²）和学生t检验分析数据。
纳入的216例患者中，112例（51.9%）存在肝硬化，69例（31.9%）有治疗史。37例（17.1%）患者出现肝病失代偿。在完成研究方案的206例患者中，173例（83.1%）实现了持续病毒学应答，三联疗法组的应答率为89.2%（25/28），索磷布韦/利巴韦林治疗组为82.2%（148/180）。初治患者的治疗应答率为86.2%（119/138），有治疗史患者的应答率为79.4%（54/68），二者相似（p值为0.19）。肝硬化患者的持续病毒学应答率为75.4%（80/106），低于无肝硬化患者的9
