Lv Duo-Duo, Wang Meng-Lan, Chen En-Qiang, Wu Dong-Bo, Tao Ya-Chao, Zhang Dong-Mei, Tang Hong
Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Eur J Gastroenterol Hepatol. 2019 Mar;31(3):382-388. doi: 10.1097/MEG.0000000000001299.
A combination of sofosbuvir (SOF)+NS5A inhibitor therapies is the main treatment for patients with hepatitis C virus (HCV) genotype-2 (GT-2) chronic infection, but the data are rarely reported in China. This study aimed to investigate the virological response and liver fibrosis improvement among GT-2 patients receiving SOF+NS5A inhibitors.
In this retrospective study, patients who received SOF+NS5A inhibitors between March 2016 and July 2017 were recruited. The treatment duration was 12 weeks and the treatment strategies included SOF+daclatasvir, SOF/ledipasvir, and SOF/velpatasvir. The primary endpoint was a sustained virologic response (serum HCV RNA undetectable) at week 12 after the end of therapy and the secondary endpoint was the improvement in liver stiffness and scores of apartate aminotransferase to platelet ratio index and fibrosis-4.
A total of 30 GT-2 patients were enrolled, with 13 (43.3%) patients in SOF+daclatasvir, 13 (43.3%) patients in SOF/ledipasvir, and four (13.3%) patients in SOF/velpatasvir. All patients [30/30 (100%)] achieved SVR, irrespective of treatment regimens and degree of liver fibrosis. After the treatment, liver fibrosis scores of apartate aminotransferase to platelet ratio index (2.27±2.14 vs. 0.89±0.77, P=0.003) and fibrosis-4 (1.17±1.22 vs. 0.42±0.25, P=0.013) were both significantly lower than those before treatment.
SOF+NS5A inhibitor therapies may induce an excellent virological response and fibrosis improvement in HCV GT-2-infected patients.
索磷布韦（SOF）联合NS5A抑制剂疗法是丙型肝炎病毒（HCV）基因2型（GT-2）慢性感染患者的主要治疗方法，但在中国相关数据报道较少。本研究旨在调查接受SOF+NS5A抑制剂治疗的GT-2患者的病毒学应答及肝纤维化改善情况。
在这项回顾性研究中，纳入了2016年3月至2017年7月期间接受SOF+NS5A抑制剂治疗的患者。治疗疗程为12周，治疗方案包括SOF+达卡他韦、SOF/来迪派韦以及SOF/维帕他韦。主要终点为治疗结束后第12周的持续病毒学应答（血清HCV RNA检测不到），次要终点为肝硬度改善以及天冬氨酸转氨酶与血小板比值指数和纤维化-4评分的改善。
共纳入30例GT-2患者，其中13例（43.3%）接受SOF+达卡他韦治疗，13例（43.3%）接受SOF/来迪派韦治疗，4例（13.3%）接受SOF/维帕他韦治疗。所有患者[30/30（100%）]均实现了持续病毒学应答，无论治疗方案及肝纤维化程度如何。治疗后，天冬氨酸转氨酶与血小板比值指数的肝纤维化评分（2.27±2.14对0.89±0.77，P=0.003）以及纤维化-4评分（1.17±1.22对0.42±0.25，P=0.013）均显著低于治疗前。
SOF+NS5A抑制剂疗法可能在HCV GT-2感染患者中诱导出良好的病毒学应答及纤维化改善效果。
