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奥贝他韦/帕利瑞韦/利托那韦、达沙布韦治疗 HIV/HCV 合并感染患者 HCV 的有效性:综合分析。

Effectiveness of ombitasvir/paritaprevir/ritonavir, dasabuvir for HCV in HIV/HCV coinfected subjects: a comprehensive analysis.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.

Key Laboratory of Infectious Diseases, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.

出版信息

Virol J. 2019 Jan 17;16(1):11. doi: 10.1186/s12985-018-1114-4.

Abstract

BACKGROUND

Data on the treatment of patients with hepatitis C virus (HCV)/human immunodeficiency virus (HIV) coinfection remains limited. A comprehensive analysis was performed to evaluate the efficacy and safety of ombitasvir (OBV)/paritaprevir (PTV)/ritonavir(r) ± dasabuvir (DSV) ± ribavirin (RBV) for treatment in HCV/HIV coinfected patients.

METHODS

We systematically searched and included studies that enrolled patients with HIV/HCV coinfection using the OBV/PTV/r ± DSV ± RBV regimens and reported sustained virological response after 12 weeks (SVR12) end-of-treatment. Heterogeneity of results was assessed and pooled SVR rates were computed with 95% confidence intervals (95%CI). Subgroup analysis and assessment of publication bias through Egger's test were further performed.

RESULTS

Ten studies containing 1358 coinfected patients were included in this study. The pooled estimate of SVR12 was 96.3% (95%CI: 95.1-97.4). Subgroup analysis showed that pooled SVR12 rate was 96.2% (95% CI: 94.8-97.4) for patients with genotype (GT) 1 and 98.8% (95% CI: 95.1-100.0) for those with GT4. The SVR12 rates for the treatment-naïve (TN) and treatment-experienced (TE) patients were 96.8% (95% CI, 94.8-98.5) and 98.9% (95% CI, 96.4-100.0), respectively. Pooled SVR12 rate was 97.8(95%CI: 94.6-99.8) for patients with cirrhosis and 96.7% (95%CI: 95.3-97.8) without cirrhosis. The pooled incidence of any adverse events (AEs) and serious adverse events (SAEs) was 73.9% (95%CI: 38.1-97.6) and 2.7% (95%CI: 0.0-9.5). Publication bias did not exist in this study.

CONCLUSIONS

The comprehensive analysis showed high efficacy for the OBV/PTV/r ± DSV ± RBV regimen in patients coinfected with HIV and HCV, regardless of genotypes, history of treatment and the presence or absence of cirrhosis.

摘要

背景

关于丙型肝炎病毒(HCV)/人类免疫缺陷病毒(HIV)合并感染患者治疗的数据仍然有限。我们进行了一项全面分析,以评估奥比帕利(OBV)/帕立瑞韦(PTV)/利托那韦(r)±达沙布韦(DSV)±利巴韦林(RBV)治疗 HCV/HIV 合并感染患者的疗效和安全性。

方法

我们系统地检索并纳入了使用 OBV/PTV/r±DSV±RBV 方案治疗 HIV/HCV 合并感染并报告 12 周治疗结束时持续病毒学应答(SVR12)的患者的研究,并报告了 SVR12 结束时的持续病毒学应答(SVR12)。评估结果的异质性,并计算 95%置信区间(95%CI)的汇总 SVR 率。进一步进行亚组分析和通过 Egger 检验评估发表偏倚。

结果

这项研究纳入了 10 项包含 1358 例合并感染患者的研究。汇总的 SVR12 估计值为 96.3%(95%CI:95.1-97.4)。亚组分析显示,基因型(GT)1 患者的 SVR12 率为 96.2%(95%CI:94.8-97.4),GT4 患者的 SVR12 率为 98.8%(95%CI:95.1-100.0)。初治(TN)和治疗经验(TE)患者的 SVR12 率分别为 96.8%(95%CI,94.8-98.5)和 98.9%(95%CI,96.4-100.0)。肝硬化患者的 SVR12 率为 97.8%(95%CI:94.6-99.8),无肝硬化患者为 96.7%(95%CI:95.3-97.8)。任何不良事件(AE)和严重不良事件(SAE)的汇总发生率为 73.9%(95%CI:38.1-97.6)和 2.7%(95%CI:0.0-9.5)。本研究不存在发表偏倚。

结论

综合分析表明,OBV/PTV/r±DSV±RBV 方案治疗 HIV 和 HCV 合并感染患者的疗效很高,无论基因型、治疗史以及是否存在肝硬化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/996c/6337763/8d77ba5991a3/12985_2018_1114_Fig1_HTML.jpg

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