Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
J Viral Hepat. 2019 Mar;26(3):316-322. doi: 10.1111/jvh.13033. Epub 2018 Dec 3.
Optional treatments for patients with chronic hepatitis C virus (HCV) genotype (GT) 6 infection have not been extensively studied. This study aimed to evaluate the safety and efficacy of sofosbuvir (SOF)-based direct-acting antiviral agents (DAAs) for HCV GT6. We performed a retrospective study at the West China Hospital of Sichuan University in Southwest China from January 2016 to May 2017. Our study screened 130 treatment-naïve patients with chronic HCV GT6 and without liver cirrhosis. A total of 60 HCV GT6 patients were ultimately enrolled. All patients received SOF-based DAAs therapy, including SOF 400 mg plus daclatasvir (DCV) 60 mg daily or SOF 400 mg plus velpatasvir (VEL) 100 mg daily for 12 weeks. The sustained virological response 12 weeks after treatment (SVR12) was 100% (60/60) in treatment-naïve patients with HCV GT6, including 100% (37/37) of patients receiving SOF plus DCV therapy and 100% (23/23) of patients receiving SOF plus VEL therapy. Measurements of liver stiffness were significantly decreased in patients at week 12 (P = 0.014) and week 24 (P < 0.001) of DAAs treatment compared to baseline values. The serum biomarker aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 score were also significantly reduced at week 12 and week 24 compared to before treatment (both P < 0.001). SOF-based therapy was well-tolerated, and no serious adverse events were reported. In conclusion, SOF plus DCV and SOF plus VEL were safe and achieved a high SVR12 rate for treatment-naïve patients with HCV GT6 without liver cirrhosis.
对于慢性丙型肝炎病毒 (HCV) 基因型 (GT) 6 感染患者,尚未广泛研究其可选治疗方法。本研究旨在评估基于索磷布韦 (SOF) 的直接作用抗病毒药物 (DAAs) 治疗 HCV GT6 的安全性和疗效。我们在中国西南部的四川大学华西医院进行了一项回顾性研究,时间为 2016 年 1 月至 2017 年 5 月。我们的研究筛选了 130 例未经治疗的慢性 HCV GT6 且无肝硬化的患者。最终共纳入 60 例 HCV GT6 患者。所有患者均接受基于 SOF 的 DAA 治疗,包括 SOF 400mg 联合每日 60mg 达卡他韦(DCV)或 SOF 400mg 联合每日 100mg 维帕他韦(VEL)治疗 12 周。初治的 HCV GT6 患者的治疗 12 周后持续病毒学应答率 (SVR12) 为 100%(60/60),其中接受 SOF+DCV 治疗的患者 SVR12 率为 100%(37/37),接受 SOF+VEL 治疗的患者 SVR12 率为 100%(23/23)。与基线值相比,在 DAA 治疗的第 12 周(P=0.014)和第 24 周(P<0.001)时,患者的肝硬度测量值显著降低。在第 12 周和第 24 周时,血清生物标志物天门冬氨酸氨基转移酶血小板比值指数 (APRI) 和纤维化-4 评分也显著低于治疗前(均 P<0.001)。SOF 为基础的治疗方法耐受性良好,未报告严重不良事件。总之,SOF+DCV 和 SOF+VEL 对无肝硬化的初治 HCV GT6 患者安全且可获得高 SVR12 率。