Hepatology Division, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA.
Gut Liver. 2017 Sep 15;11(5):711-720. doi: 10.5009/gnl16447.
BACKGROUND/AIMS: The approval of sofosbuvir (SOF), a direct-acting antiviral, has revolutionized the treatment of chronic hepatitis C virus (HCV).
We assessed the sustained virological response (SVR) of SOF-based regimens in a real-world single-center setting for the treatment of chronic HCV genotype 1 (G1) patients. This was a retrospective review of chronic HCV G1 adult patients treated with a SOF-based regimen at Virginia Mason Medical Center between December 2013 and August 2015.
The cohort comprised 343 patients. Patients received SOF+ledipasvir (LDV) (n=155), SOF+simeprevir (SIM) (n=154), or SOF+peginterferon (PEG)+ribavirin (RBV) (n=34). Of the patients, 50.1% (n=172) had cirrhosis. The SVR rate was 92.2% for SOF/LDV, 87.0% for SOF/SIM, and 82.4% for SOF/PEG/RBV. Compared with the cirrhotic patients, the patients without cirrhosis had a higher SVR (96.8% vs 85.5%, p=0.01, SOF/LDV; 98.2% vs 80.6%, p=0.002, SOF/SIM; 86.4% vs 75.0%, p=0.41, SOF/PEG/RBV). In this study, prior treatment experience adversely affected the response rate in subjects treated with SOF/PEG/RBV.
In this single-center, real-world setting, the treatment of chronic HCV G1 resulted in a high rate of SVR, especially in patients without cirrhosis.
背景/目的：直接作用抗病毒药物索非布韦（SOF）的批准彻底改变了慢性丙型肝炎病毒（HCV）的治疗方法。
我们评估了 SOF 为基础的方案在真实世界中的单中心环境中治疗慢性 HCV 基因型 1（G1）患者的持续病毒学应答（SVR）。这是对 2013 年 12 月至 2015 年 8 月在弗吉尼亚梅森医疗中心接受 SOF 为基础方案治疗的慢性 HCV G1 成年患者进行的回顾性研究。
该队列包括 343 名患者。患者接受 SOF+雷迪帕韦（LDV）（n=155）、SOF+西美瑞韦（SIM）（n=154）或 SOF+聚乙二醇干扰素（PEG）+利巴韦林（RBV）（n=34）治疗。患者中有 50.1%（n=172）患有肝硬化。SOF/LDV、SOF/SIM 和 SOF/PEG/RBV 的 SVR 率分别为 92.2%、87.0%和 82.4%。与肝硬化患者相比，无肝硬化患者的 SVR 更高（SOF/LDV 为 96.8%比 85.5%，p=0.01；SOF/SIM 为 98.2%比 80.6%，p=0.002；SOF/PEG/RBV 为 86.4%比 75.0%，p=0.41）。在这项研究中，SOF/PEG/RBV 治疗组中既往治疗经验对反应率有不利影响。
在这个单中心的真实世界环境中，治疗慢性 HCV G1 导致 SVR 率很高，尤其是在无肝硬化的患者中。
