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埃及血液透析患者丙型肝炎感染的治疗:梦想成真。

Treatment of hepatitis C infection among Egyptian hemodialysis patients: the dream becomes a reality.

机构信息

Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Nephrology Department, Port-Said University, Port Fuad, Egypt.

出版信息

Int Urol Nephrol. 2019 Sep;51(9):1639-1647. doi: 10.1007/s11255-019-02246-7. Epub 2019 Jul 30.

Abstract

BACKGROUND AND AIMS

New direct-acting antiviral drugs have become the corner-stone treatment for HCV infection: they show promising results with accepted side-effects and low dropout rates. One of the available regimens is paritaprevir/ombitasvir/ritonavir (PTV/OMV/RTV). Our aim was to study the efficacy and safety of this drug regimen among HCV-positive hemodialysis patients.

METHODS

This prospective single-center study was performed in the Urology and Nephrology Center, Mansoura University, Egypt. Ninety-six maintenance hemodialysis patients were screened for HCV antibodies. Positive results were found in 46 patients (47.9%). HCV PCR was assessed in all HCV-antibody-positive patients; positive results were found positive for 38 (82%); all patients were HCV genotype 4. Four patients were excluded due to advanced liver cirrhosis, liver malignancy, or metastatic breast cancer. Thirty-four patients were prescribed PTV/OMV/RTV for 3 months to treat HCV.

RESULTS

Mean age was 43.2 ± 11.9 years. Most patients were male (67.6%). There was a rapid response to treatment: HCV PCR became negative by 4 weeks after starting treatment. By 12 and 24 weeks post-DAA therapy, there was a sustained viral response (SVR 12, SVR 24) in 100% of patients with improved liver-enzyme levels.

CONCLUSION

The PTV/OMV/RTV regimen was safe and effectively treated Egyptian HCV-positive genotype-4 hemodialysis patients.

摘要

背景与目的

新型直接作用抗病毒药物已成为 HCV 感染的基石治疗方法:它们具有可接受的副作用和低停药率,显示出有前途的疗效。其中一种可用方案是帕利瑞韦/奥比他韦/利托那韦(PTV/OMV/RTV)。我们的目的是研究该药物方案在 HCV 阳性血液透析患者中的疗效和安全性。

方法

这项前瞻性单中心研究在埃及曼苏拉大学泌尿科和肾脏病中心进行。对 96 名维持性血液透析患者进行 HCV 抗体筛查。在 46 名(47.9%)阳性结果中发现 HCV 阳性。对所有 HCV 抗体阳性患者进行 HCV PCR 评估;在 38 名阳性结果中发现(82%)为 HCV 基因型 4。由于晚期肝硬化、肝脏恶性肿瘤或转移性乳腺癌,4 名患者被排除在外。34 名患者被开处 PTV/OMV/RTV 方案治疗 3 个月以治疗 HCV。

结果

平均年龄为 43.2±11.9 岁。大多数患者为男性(67.6%)。治疗反应迅速:开始治疗后 4 周 HCV PCR 转为阴性。在 DAA 治疗后 12 周和 24 周时,100%的患者出现持续病毒学应答(SVR12,SVR24),肝酶水平得到改善。

结论

PTV/OMV/RTV 方案治疗埃及 HCV 阳性基因型 4 血液透析患者安全有效。

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