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口服抗病毒药物(索磷布韦/来迪帕司韦)治疗儿童丙型肝炎病毒感染的有效性。

The effectiveness of oral antiviral (Sofosbuvir/Ledipasvir) in treating children with HCV infection.

作者信息

Alkaaby Ban Adil, Al-Ethawi Abd El-Salam

机构信息

Ban Adil Al-Kaaby, MRCPCh, FICMS-Ped., Senior Lecturer, Paediatrics Department, Al-Mustansiryah Medical College, Specialist Pediatrician at Central Child Teaching Hospital & Gastroenterology and Hepatology Center, Baghdad, Iraq.

Abd El-Salam Al-Ethawi, Senior Lecturer, Pediatrics Department, Al-Mustansiryah Medical College, Paediatrics Cardiologist at Ibn Al-Bittar Center for Cardiac Surgery and Central Child Teaching Hospital, Baghdad, Iraq.

出版信息

Pak J Med Sci. 2018 Nov-Dec;34(6):1353-1356. doi: 10.12669/pjms.346.15722.

Abstract

OBJECTIVES

To determine the efficacy of (Sofosbuvir/ledipasvir) in treating children with HCV infection.

METHODS

This study was conducted at Gastroenterology, Hepatology Center /Pediatrics department and the Central Child Teaching Hospital, Baghdad / Iraq from April 2017 to January 2018. Patients with positive HCV PCR, aged 7 to 18 years were enrolled. History, clinical examinations and investigations were conducted. HCV genotyping was done (if affordable). Sofosbuvir/Ledipasvir was given to all patients once daily. Ribavirin was added for INF-experienced patients or with established cirrhosis. Follow up with liver function and renal function and PCR was done at 12 weeks (end of treatment); then after 12 weeks post treatment (SVR12). Total duration of therapy was 12 weeks, extended to 24 in cases with established cirrhosis. Computer program SPSS version 20 was used for data analysis.

RESULTS

The number of patients was 22, with mean age of 12.5 years, 14 boys (63.6%), and 8 girls (36.4%). Genotype 1 was the dominant type (75%). SVR 12 was achieved in 20 patients (90.9%), the remaining two (9.1%) had partial virological response. HBV co-infection was found in five cases; they were kept on Entecavir during the course of treatment. All achieved SVR12 for HCV with decrease in titer of HBV. Even INF-experienced patients (7 patients 31.8%) were responsive with SVR12. The treatment was well tolerated.

CONCLUSION

Sofosbuvir/ledipasvir is effective in treating HCV in children, and is well tolerated.

摘要

目的

确定索磷布韦/维帕他韦治疗丙型肝炎病毒(HCV)感染儿童的疗效。

方法

本研究于2017年4月至2018年1月在伊拉克巴格达的胃肠病学、肝病中心/儿科以及中央儿童教学医院开展。纳入HCV PCR检测呈阳性、年龄在7至18岁的患者。进行病史采集、临床检查和各项检查。进行HCV基因分型(如果费用可承受)。所有患者均每日服用一次索磷布韦/维帕他韦。对于曾接受过干扰素治疗的患者或已确诊肝硬化的患者加用利巴韦林。在治疗12周(治疗结束时)进行肝功能、肾功能和PCR检测随访;然后在治疗后12周(SVR12)进行随访。治疗总疗程为12周,对于已确诊肝硬化的患者延长至24周。使用计算机程序SPSS 20版进行数据分析。

结果

患者数量为22例,平均年龄12.5岁,其中14名男孩(63.6%),8名女孩(36.4%)。基因1型为主要类型(75%)。20例患者(90.9%)实现了SVR 12,其余2例(9.1%)有部分病毒学应答。发现5例患者合并HBV感染;在治疗过程中给予恩替卡韦。所有患者HCV均实现SVR12,且HBV滴度下降。即使是曾接受过干扰素治疗的患者(7例,31.8%)对SVR12也有反应。该治疗耐受性良好。

结论

索磷布韦/维帕他韦治疗儿童HCV有效,且耐受性良好。

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