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含奥比他韦/帕利瑞韦/利托那韦方案治疗初治和经治慢性丙型肝炎基因型 4 的高成功率:真实世界结果。

High success rates for the use of ombitasvir/paritaprevir/ritonavir containing regimens in treatment of naïve and experienced chronic hepatitis C genotype 4: Real world results.

机构信息

Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt.

Department of Internal Medicine, Al-Azhar University, Cairo, Egypt.

出版信息

J Med Virol. 2022 Feb;94(2):667-674. doi: 10.1002/jmv.25478. Epub 2019 Apr 15.

Abstract

INTRODUCTION AND AIMS

Treatment of hepatitis C virus (HCV) genotype 4 patient with fixed dose combination of ombitasvir-paritaprevir-ritonavir plus ribavirin (OBV/rPTV/RBV) has been proven efficacy and safety in many clinical trials. The current study reports the efficacy and safety of OBV/rPTV/RBV (for treatment-naïve), and OBV/rPTV/RBV/sofosbuvir (SOF) (for treatment-experienced), in chronic HCV genotype 4 patients in real life settings.

METHODS

Prospective cohort study including all adult chronic HCV genotype 4 patients who were scheduled to receive OBV/rPTV/RBV ± SOF for 12 or 24 weeks in New Cairo Viral Hepatitis Treatment Center. The primary efficacy endpoint was a virologic response at posttreatment week 12 (SVR12). Changes in hematological parameters, liver biochemical profile and fibrosis-4 index (FIB-4), as well as clinical and laboratory adverse events (AEs) across follow up visits (week 4, end of treatment [EOT], and SVR12), were recorded.

RESULTS

Our study included 325 patients (age; 47.63 ± 12.63 years, 55.38% [n = 180] men). Most of the included patients (89.85%, n = 292) were treatment naïve and only 7% (n = 23) had liver cirrhosis. Overall, SVR12 was attained by 98.44% (316 of 321) of the patients; 97.15% (307 of 316) of patients who received 12 weeks of OBV/rPTV/RBV ± SOF and 100% (9 of 9) of patients who received 24 weeks of OBV/rPTV/RBV as assessed by modified intention to treat analysis. There was a significant improvement of baseline alanine aminotransferase, aspartate aminotransferase, hemoglobin, FIB-4 at SVR12 (P < 0.05). The most common reported AEs were anemia (n = 106), fatigue (n = 41) and elevated indirect bilirubin (n = 37).

CONCLUSION

OBV/rPTV/RBV (±SOF) is a highly effective therapy for chronic HCV patients in real life settings.

摘要

简介和目的

在许多临床试验中,已证明固定剂量组合奥贝他韦/帕利瑞韦/利托那韦加利巴韦林(OBV/rPTV/RBV)治疗丙型肝炎病毒(HCV)基因型 4 患者的疗效和安全性。本研究报告了 OBV/rPTV/RBV(初治)和 OBV/rPTV/RBV/索磷布韦(SOF)(经治)在新开罗病毒性肝炎治疗中心接受治疗的慢性 HCV 基因型 4 患者的真实生活环境中的疗效和安全性。

方法

这是一项前瞻性队列研究,纳入了所有计划接受 OBV/rPTV/RBV±SOF 治疗 12 或 24 周的慢性 HCV 基因型 4 成年患者。主要疗效终点是治疗后第 12 周(SVR12)的病毒学应答。记录治疗结束时(EOT)和 SVR12 时(第 4 周、EOT 和 SVR12)的血液学参数、肝生化谱和纤维化-4 指数(FIB-4)变化以及临床和实验室不良事件(AE)。

结果

本研究纳入了 325 名患者(年龄 47.63±12.63 岁,55.38%[n=180]为男性)。大多数纳入的患者(89.85%,n=292)为初治患者,只有 7%(n=23)患有肝硬化。总体而言,321 名患者中的 98.44%(316 名)获得了 SVR12;12 周 OBV/rPTV/RBV±SOF 治疗的 307 名患者中的 97.15%(307 名)和 24 周 OBV/rPTV/RBV 治疗的 9 名患者中的 100%(9 名)获得了 SVR12,这是通过改良意向治疗分析评估的。SVR12 时丙氨酸氨基转移酶、天冬氨酸氨基转移酶、血红蛋白和 FIB-4 均有显著改善(P<0.05)。最常见的报告 AE 是贫血(n=106)、疲劳(n=41)和间接胆红素升高(n=37)。

结论

OBV/rPTV/RBV(±SOF)在真实生活环境中是治疗慢性 HCV 患者的一种非常有效的治疗方法。

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