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达卡他韦联合asunaprevir 治疗丙型肝炎病毒 1b 型感染患者的真实世界疗效、肝硬度和纤维化标志物变化及安全性。

Daclatasvir Plus Asunaprevir for the Treatment of Patients with Hepatitis C Virus Genotype 1b Infection: Real-World Efficacy, Changes in Liver Stiffness and Fibrosis Markers, and Safety.

机构信息

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Gut Liver. 2018 May 15;12(3):324-330. doi: 10.5009/gnl17298.

Abstract

BACKGROUND/AIMS: The treatment with daclatasvir plus asunaprevir (DCV+ASV) is associated with potent antiviral effects in patients with genotype 1b hepatitis C virus (HCV) infection. We investigated the real-world efficacy, changes in liver stiffness and noninvasive fibrosis markers, and the safety of DCV+ASV treatment in Korean patients.

METHODS

In total, 363 patients with chronic hepatitis C were treated with DCV+ASV between August 2015 and January 2017. Finally, we analyzed the data of 270 patients who were monitored for at least 12 weeks after the end of treatment.

RESULTS

The mean age was 60.7 years, and females predominated (60.4%). Most patients (64.8%) were treatment-naïve, and 56 patients (20.7%) had cirrhosis. Two hundred fifty-seven (95.2%) and 251 (93.0%) patients achieved end-of-treatment responses and sustained virological responses at 12 weeks posttreatment (SVR12), respectively. The SVR12 rates were higher in patients who were <65 years of age, males, without cirrhosis and had lower HCV RNA levels. All LS values and fibrosis-4 and aspartate aminotransferase-to-platelet ratio index values declined from baseline to the time of assessment of SVR12.

CONCLUSIONS

The DCV+ASV therapy resulted in a high SVR12 and improved liver fibrosis; the treatment was well tolerated in patients with genotype 1b HCV infections.

摘要

背景/目的:达卡他韦联合asunaprevir(DCV+ASV)治疗与基因型 1b 丙型肝炎病毒(HCV)感染患者的强效抗病毒作用相关。我们研究了 DCV+ASV 治疗在韩国患者中的真实疗效、肝硬度和非侵入性纤维化标志物的变化以及安全性。

方法

2015 年 8 月至 2017 年 1 月,共有 363 例慢性丙型肝炎患者接受了 DCV+ASV 治疗。最终,我们分析了 270 例在治疗结束后至少 12 周接受监测的患者的数据。

结果

患者的平均年龄为 60.7 岁,女性居多(60.4%)。大多数患者(64.8%)为初治患者,56 例(20.7%)患有肝硬化。257 例(95.2%)和 251 例(93.0%)患者分别在治疗结束时和治疗结束后 12 周时达到了治疗结束应答和持续病毒学应答(SVR12)。年龄<65 岁、男性、无肝硬化和 HCV RNA 水平较低的患者 SVR12 率较高。所有 LS 值和纤维化-4 和天冬氨酸氨基转移酶-血小板比值指数值均从基线下降到 SVR12 的评估时间。

结论

DCV+ASV 治疗可获得高 SVR12 和改善肝纤维化;该治疗在基因型 1b HCV 感染患者中耐受性良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bb7/5945264/1eff43844fd3/gnl-12-324f1.jpg

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