Mohamed Mohamed S, Hanafy Amr S, Bassiony Mohamed A A, Hussein Samia
Departments of aInternal Medicine bMedical Biochemistry and Molecular Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Eur J Gastroenterol Hepatol. 2017 Dec;29(12):1368-1372. doi: 10.1097/MEG.0000000000000963.
Interferon-free direct-acting antivirals (DAA) combination therapies, including sofosbuvir (SOF) and daclatasvir (DCV) therapy, eradicate chronic hepatitis C virus (HCV) in a high percentage of patients, but its impact on improvements in liver function is unclear. The aim of this study was to investigate the changes in clinical and biochemical parameters reflecting liver function and general status in those who achieved HCV eradication by DAA.
From March 2016 to October 2016, 374 chronic hepatitis C patients were enrolled for this prospective, observational study and received SOF, DCV with ribavirin, to evaluate the changes in liver function parameters, international normalized ratio, complete blood count, model for end-stage liver disease, and Child-Turcotte-Pugh scores after achieving a sustained virological response 12 weeks after treatment.
In those who achieved HCV clearance, liver function parameters, serum albumin, bilirubin, platelet count, and international normalized ratio improved significantly in the majority of patients; the reduction in the model for end-stage liver disease score was (-2.36, SE 0.15, P<0.001). 44% of the patients showed an improved Child-Turcotte-Pugh score, 51% showed no change, and only 5% showed deterioration.
Successful HCV eradication by DAAs including SOF, DCV with ribavirin therapy improved liver function parameters and clinical outcomes in chronic hepatitis C patients.
不含干扰素的直接抗病毒药物（DAA）联合疗法，包括索磷布韦（SOF）和达卡他韦（DCV）疗法，可在高比例患者中根除慢性丙型肝炎病毒（HCV），但其对肝功能改善的影响尚不清楚。本研究旨在调查通过DAA实现HCV根除的患者中反映肝功能和一般状况的临床及生化参数的变化。
2016年3月至2016年10月，374例慢性丙型肝炎患者纳入这项前瞻性观察性研究，接受SOF、DCV联合利巴韦林治疗，以评估治疗12周后获得持续病毒学应答后肝功能参数、国际标准化比值、全血细胞计数、终末期肝病模型及Child-Turcotte-Pugh评分的变化。
在实现HCV清除的患者中，大多数患者的肝功能参数、血清白蛋白、胆红素、血小板计数及国际标准化比值显著改善；终末期肝病模型评分降低值为（-2.36，标准误0.15，P<0.001）。44%的患者Child-Turcotte-Pugh评分改善，51%无变化，仅5%恶化。
包括SOF、DCV联合利巴韦林疗法在内的DAA成功根除HCV可改善慢性丙型肝炎患者的肝功能参数及临床结局。
