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在日本,ombitasvir/paritaprevir/ritonavir与利巴韦林联合用药对2a基因型慢性肝炎患者的疗效及安全性

Efficacy and safety of ombitasvir/paritaprevir/ritonavir and ribavirin for chronic hepatitis patients infected with genotype 2a in Japan.

作者信息

Atsukawa Masanori, Tsubota Akihito, Toyoda Hidenori, Takaguchi Koichi, Nakamuta Makoto, Watanabe Tsunamasa, Tada Toshifumi, Tsutsui Akemi, Ikeda Hiroki, Abe Hiroshi, Kato Keizo, Uojima Haruki, Ikegami Tadashi, Asano Toru, Kondo Chisa, Koeda Mai, Okubo Tomomi, Arai Taeang, Iwashita-Nakagawa Ai, Itokawa Norio, Kumada Takashi, Iwakiri Katsuhiko

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo.

Core Research Facilities for Basic Science, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo.

出版信息

Hepatol Res. 2019 Apr;49(4):369-376. doi: 10.1111/hepr.13292. Epub 2019 Jan 2.

Abstract

AIM

The aim of this study was to evaluate the efficacy and safety of community-based ombitasvir/paritaprevir/ritonavir plus ribavirin therapy for non-cirrhotic patients with hepatitis C virus (HCV) genotype 2a infection in a real-world setting.

METHODS

Patients with HCV genotype 2a infection were enrolled in this study and received the therapy for 16 weeks at 11 specialized centers in Japan between October 2016 and July 2017. Among the 98 patients participating in the study, four patients were excluded because of the presence of cirrhosis and/or genotype 2b infection. The remaining 94 patients were subjected to the analysis.

RESULTS

The patients consisted of 38 women and 56 men, with a median age of 63 years. The rate of sustained virologic response (SVR) was 97.9%. The SVR rates were similar between patients with and without ribavirin dose reduction (96.0% vs. 98.6%, respectively). Of the two patients in whom treatment failed, one patient completed the treatment but relapsed at 4 weeks post-treatment, whereas the other did not show virologic response and therefore discontinued treatment at week 9. At baseline, both patients had non-structural protein (NS)5A resistance-associated substitution (RAS) L31M but no NS3 RAS. At the time of relapse, the patient had NS5A RAS F28S. At the premature treatment discontinuation, the non-responder had NS3 RAS D168V and NS5A RAS T24S. Ribavirin-induced anemia was the most frequent adverse event.

CONCLUSION

Community-based, 16-week, ombitasvir/paritaprevir/ritonavir plus ribavirin therapy was highly efficacious and safe in non-cirrhotic patients with HCV genotype 2a infection in a real-world setting.

摘要

目的

本研究旨在评估在真实世界中,基于社区的奥比他韦/帕利瑞韦/利托那韦联合利巴韦林疗法治疗非肝硬化丙型肝炎病毒(HCV)2a基因型感染患者的疗效和安全性。

方法

2016年10月至2017年7月期间,HCV 2a基因型感染患者在日本11个专业中心入组本研究,并接受了16周的治疗。参与研究的98例患者中,4例因存在肝硬化和/或2b基因型感染而被排除。其余94例患者纳入分析。

结果

患者包括38名女性和56名男性,中位年龄为63岁。持续病毒学应答(SVR)率为97.9%。利巴韦林剂量减少和未减少的患者SVR率相似(分别为96.0%和98.6%)。在治疗失败的2例患者中,1例完成了治疗,但在治疗后4周复发,而另1例未出现病毒学应答,因此在第9周停止治疗。基线时,2例患者均有非结构蛋白(NS)5A耐药相关置换(RAS)L31M,但无NS3 RAS。复发时,该患者有NS5A RAS F28S。在提前停止治疗时,无应答者有NS3 RAS D168V和NS5A RAS T24S。利巴韦林引起的贫血是最常见的不良事件。

结论

在真实世界中,基于社区的16周奥比他韦/帕利瑞韦/利托那韦联合利巴韦林疗法治疗非肝硬化HCV 2a基因型感染患者高度有效且安全。

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