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国家治疗政策的即时调整使所有接受治疗的患者实现了令人惊讶的丙型肝炎病毒抑制:埃及的真实经验

Spur-of-the-Moment Modification in National Treatment Policies Leads to a Surprising HCV Viral Suppression in All Treated Patients: Real-Life Egyptian Experience.

作者信息

El Kassas Mohamed, Omran Dalia, Elsaeed Kadry, Alboraie Mohamed, Elakel Wafaa, El Tahan Adel, Abd El Latif Yasmeen, Nabeel Mohamed Mahmoud, Korany Mohamed, Ezzat Sameera, El-Serafy Magdy, ElShazly Yehia, Doss Wahid, Esmat Gamal

机构信息

1 Endemic Medicine Department, Faculty of Medicine, Helwan University , Cairo, Egypt .

2 Endemic Medicine and Hepato-Gastroenterology Department, Faculty of Medicine, Cairo University , Cairo, Egypt .

出版信息

J Interferon Cytokine Res. 2018 Feb;38(2):81-85. doi: 10.1089/jir.2017.0121. Epub 2018 Jan 22.

DOI:10.1089/jir.2017.0121
PMID:29356573
Abstract

The aim of this study was to retrospectively analyze the outcome of an unscheduled change in national Egyptian policies for the treatment of hepatitis C virus (HCV), which was transpired as a result of a reduction in interferon supplies, and to manage patients who already started interferon-based therapy. After completing a priming 4-weeks course of sofosbuvir/pegylated interferon/ribavirin (SOF/PEG IFN/RBV), a 12-weeks course of sofosbuvir/daclatasvir (SOF/DCV) combination was initiated. We evaluated the sustained virologic response at 12 weeks posttreatment (SVR12) for 2 groups of patients; Group 1, which included patients who had the previous regimen with IFN priming, and group 2, which included the first consecutive group of patients who received SOF/DCV for 12 weeks from the start without IFN priming. All group 1 patients (1,214 patients) achieved SVR12 (100%) and this was statistically significant when compared with the overall SVR12 in group 2 [8,869 patients with sustained virologic response [SVR] of 98.9%] (P value <0.001). No serious adverse events were reported in both groups. In this real-life treatment experience, interferon-based directly acting antiviral treatment with SOF/PEG IFN/RBV as a priming for 4 weeks, followed by SOF/DCV combination for 12 weeks, led to HCV viral suppression in all treated patients.

摘要

本研究的目的是回顾性分析埃及全国丙型肝炎病毒(HCV)治疗政策意外变更的结果,该变更是由于干扰素供应减少所致,并对已开始基于干扰素治疗的患者进行管理。在完成4周的索磷布韦/聚乙二醇干扰素/利巴韦林(SOF/PEG IFN/RBV)初始疗程后,开始12周的索磷布韦/达卡他韦(SOF/DCV)联合治疗。我们评估了两组患者治疗后12周的持续病毒学应答(SVR12);第1组包括接受过IFN初始治疗方案的患者,第2组包括从开始就连续接受12周SOF/DCV治疗且未进行IFN初始治疗的第一组患者。所有第1组患者(1214例)均实现了SVR12(100%),与第2组的总体SVR12[8869例患者的持续病毒学应答(SVR)为98.9%]相比,这具有统计学意义(P值<0.001)。两组均未报告严重不良事件。在这种实际治疗经验中,以SOF/PEG IFN/RBV为初始治疗4周,随后使用SOF/DCV联合治疗12周的基于干扰素的直接抗病毒治疗,使所有接受治疗的患者实现了HCV病毒抑制。

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引用本文的文献

1
Towards hepatitis C virus elimination: Egyptian experience, achievements and limitations.迈向丙型肝炎病毒消除:埃及的经验、成就和局限。
World J Gastroenterol. 2018 Oct 14;24(38):4330-4340. doi: 10.3748/wjg.v24.i38.4330.