Jamil Zubia, Waheed Yasir, Malik Maryam, Durrani Asghar A
Department of Medicine, Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan.
Multidisciplinary Laboratory, Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan.
PeerJ. 2018 May 25;6:e4853. doi: 10.7717/peerj.4853. eCollection 2018.
The annual global deaths from viral hepatitis is 1.4 million. Pakistan has the second highest burden of hepatitis C in the world. There is dire need to evaluate the response of new direct acting antivirals for the treatment of hepatitis C patients in Pakistan. World Health Organization has developed a strategy to treat 80% of HCV patients by 2030. In Pakistan, HCV treatment rate is 1%. The aim of the study was to analyze the effect of Sofosbuvir plus Ribavirin therapy on HCV patients in Pakistan.
An observational study was conducted at Fauji Foundation Hospital Rawalpindi from November-2016 to July-2017. All the drugs were administered according to the guidelines of Asia Pacific Association for the Study of Liver (APASL) for the treatment of HCV patients. A total 327 chronic HCV patients were enrolled in the study and 304 completed the treatment. Patients belonged to three different groups including treatment: Naïve patients ( = 107), Non-Responder patients ( = 126) and patients who relapsed to Interferon therapy ( = 71) All the patients were given Sofosbuvir plus Ribavirin therapy for 24 weeks and the early virological response (EVR) and end treatment response (ETR) was calculated. Different parameters including patient age, viral load, viral genotype, blood picture, ultrasound findings and liver function tests were also studied.
Out of 304 patients, 301 (99%) achieved EVR and 300 achieved ETR (98.7%). End treatment response was 95.6% in HCV genotype 1 and 98.9% in HCV genotype 3 patients. ETR was 99.06% in treatment Naïve, 99.20% in non-responders and 97.18% in previously relapsed patients. We did not find the association of any host and viral factor in the determination of EVR and ETR.
The Sofosbuvir plus Ribavirin treatment is highly effective, safe and cost-effective for the treatment of hepatitis C patients in Pakistan.
全球每年因病毒性肝炎死亡的人数为140万。巴基斯坦是世界上丙型肝炎负担第二重的国家。迫切需要评估新型直接抗病毒药物对巴基斯坦丙型肝炎患者治疗的反应。世界卫生组织制定了一项战略，到2030年治疗80%的丙型肝炎病毒（HCV）患者。在巴基斯坦，HCV治疗率为1%。本研究的目的是分析索磷布韦联合利巴韦林疗法对巴基斯坦HCV患者的疗效。
2016年11月至2017年7月在拉瓦尔品第的法吉基金会医院进行了一项观察性研究。所有药物均按照亚太肝脏研究协会（APASL）治疗HCV患者的指南给药。共有327例慢性HCV患者纳入研究，304例完成治疗。患者分为三个不同组，包括：初治患者（n = 107）、无反应患者（n = 126）和干扰素治疗后复发患者（n = 71）。所有患者均接受索磷布韦联合利巴韦林治疗24周，并计算早期病毒学反应（EVR）和治疗结束反应（ETR）。还研究了不同参数，包括患者年龄、病毒载量、病毒基因型、血常规、超声检查结果和肝功能检查。
304例患者中，301例（99%）实现了EVR，300例实现了ETR（98.7%）。HCV基因1型患者的治疗结束反应为95.6%，HCV基因3型患者为98.9%。初治患者的ETR为99.06%，无反应患者为99.20%，既往复发患者为97.18%。我们未发现任何宿主和病毒因素与EVR和ETR的确定有关。
索磷布韦联合利巴韦林治疗对巴基斯坦丙型肝炎患者高效、安全且具有成本效益。
