12周的维帕他韦加索磷布韦方案在初治的轻度纤维化丙型肝炎病毒感染者中的疗效:一项荟萃分析。

Efficacy of 12-weeks velpatasvir plus sofosbuvir-based regimen in HCV-naive subjects with mild fibrosis: a meta-analysis.

作者信息

Pisaturo Mariantonietta, Russo Antonio, Onorato Lorenzo, Coppola Nicola

机构信息

Department of Mental Health and Public Medicine - Infectious Diseases Unit. University of Campania Luigi Vanvitelli , ITALY.

Infectious Diseases Unit, AORN Caserta, Italy

出版信息

Acta Biomed. 2019 May 23;90(2):187-196. doi: 10.23750/abm.v90i2.8374.

Abstract

BACKGROUND AND AIMS

In literature systematic data on treatment with the fixed-dose combination of sofosbuvir and velpatasvir for 12 weeks in anti-HCV/HCV RNA positive subjects with mild fibrosis and naïve to previous Interferon free regimen are scanty. A meta-analysis has been performed to evaluate the efficacy of velpatasvir plus sofosbuvir combination in these patients.

METHODS

All randomized or non-randomized studies,  investigating the sustained virological response rate to sofosbuvir plus velpatasvir without ribavirin for 12 weeks in subjects naïve to previous DAA therapy and with fibrosis F0-F2 or F0-F3, were included in the meta-analysis.

RESULTS

A total of 16 studies enrolling 4,907 subjects met the inclusion criteria and were included in this meta-analysis. The prevalence of SVR by sofosbuvir and velpatasvir was 98% (95% CI 96-99%) in the 4,907 subjects without cirrhosis. The prevalence of SVR was similar considering the 9 clinical studies and the 7 real-world studies (98%, CI 95%: 96-99% and 98%; CI 95%: 96-99%, respectively). Considering the 4 studies enrolling 1,371 subjects without advanced liver fibrosis the prevalence of SVR was also high [96% (95% CI: 94-98%)]. Data indicate a prevalence of SVR ranging to 95-100% according to the different HCV genotypes.

CONCLUSION

Sofosbuvir plus velpatasvir therapeutic regimen was highly effective in HCV patients without advanced liver disease naïve to previous DAA regimen independently the different HCV genotypes.

摘要

背景与目的

在文献中,关于索磷布韦和维帕他韦固定剂量联合用药12周治疗抗-HCV/HCV RNA阳性、轻度纤维化且未接受过既往无干扰素治疗方案的受试者的系统性数据较少。已进行一项荟萃分析以评估维帕他韦加索磷布韦联合用药在这些患者中的疗效。

方法

所有随机或非随机研究,只要是调查既往未接受过直接抗病毒药物(DAA)治疗、纤维化程度为F0-F2或F0-F3的受试者使用索磷布韦加维帕他韦且无利巴韦林治疗12周后的持续病毒学应答率,均纳入该荟萃分析。

结果

共有16项研究纳入了4907名受试者,符合纳入标准并被纳入该荟萃分析。在4907名无肝硬化的受试者中,索磷布韦和维帕他韦的持续病毒学应答率为98%(95%置信区间96-99%)。考虑9项临床研究和7项真实世界研究,持续病毒学应答率相似(分别为98%,95%置信区间:96-99%和98%;95%置信区间:96-99%)。考虑4项纳入1371名无严重肝纤维化受试者的研究,持续病毒学应答率也很高[96%(95%置信区间:94-98%)]。数据表明,根据不同的HCV基因型,持续病毒学应答率在95%-100%之间。

结论

索磷布韦加维帕他韦治疗方案在既往未接受过DAA方案的无严重肝脏疾病的HCV患者中非常有效,与不同的HCV基因型无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a09f/6776220/ca2e3681a0c6/ACTA-90-187-g001.jpg

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