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8 周与 12 周奥贝他韦/帕利瑞韦/利托那韦与达萨布韦联合治疗初治非肝硬化 1b 型丙型肝炎病毒感染患者的疗效比较。

Comparative effectiveness of 8 versus 12 weeks of Ombitasvir/Paritaprevir/ritonavir and Dasabuvir in treatment-naïve patients infected with HCV genotype 1b with non-advanced hepatic fibrosis.

机构信息

Department of Infectious Diseases, Voivodeship Hospital and Jan Kochanowski University, Kielce, Poland.

Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland.

出版信息

Adv Med Sci. 2020 Mar;65(1):12-17. doi: 10.1016/j.advms.2019.09.002. Epub 2019 Dec 13.

Abstract

PURPOSE

Since 2017 treatment-naïve patients infected with genotype 1b of hepatitis C virus and minimal or moderate fibrosis can be treated with Ombitasvir/Paritaprevir/ritonavir + Dasabuvir (OPrD) for 8 weeks according to updated Summary of Product Characteristics. The aim of our study was to assess the comparative efficacy of 8 and 12-weeks therapy with OPrD in large cohort of patients eligible for 8 weeks regimen treated in real-world setting.

MATERIALS AND METHODS

We analysed data of 3067 HCV genotype 1b infected patients treated with OPrD between 2015 and 2017. Final analysis included patients with none, minimal or moderate fibrosis (F0-F2).

RESULTS

A total of 771 patients were enrolled in the study, including 197 (26%) treated for 8-weeks and 574 patients fulfilling criteria for 8-weeks but assigned to 12-weeks regimen. Majority of patients had no or minimal fibrosis (F0-F1). Longer treatment duration was more often administered in patients with moderate fibrosis, comorbidities, concomitant medications. SVR was achieved in 186 (94%) patients treated for 8 weeks and 558 (97%) for 12 weeks (p = 0.07). After exclusion of lost to follow-up patients, sustained virological response (SVR) rate reached 95% and 99%, respectively (p = 0.01). We were not able to identify factors associated with non-response.

CONCLUSIONS

This real-word experience study confirmed similar, high effectiveness of 8 and 12-weeks regimens of OPrD in genotype 1b HCV infected patients with non-advanced fibrosis. Despite of reduced SVR rate after 8-weeks regimen, there is no need to extend therapy to 12-weeks in vast majority of such patients and no need to add ribavirin.

摘要

目的

自 2017 年以来,对于初治的基因型 1b 丙型肝炎病毒感染且纤维化程度为轻度或中度的患者,根据最新的产品特性摘要,可采用奥比他韦/帕利瑞韦/利托那韦+达沙布韦(OPrD)治疗 8 周。本研究的目的是评估在现实环境中,对符合 8 周治疗方案的大量患者采用 OPrD 进行 8 周和 12 周治疗的疗效。

材料和方法

我们分析了 2015 年至 2017 年期间接受 OPrD 治疗的 3067 例基因型 1b 丙型肝炎病毒感染患者的数据。最终分析纳入了无、轻度或中度纤维化(F0-F2)的患者。

结果

共有 771 例患者入组本研究,其中 197 例(26%)接受 8 周治疗,574 例符合 8 周治疗标准但被分配至 12 周治疗方案。大多数患者纤维化程度为无或轻度(F0-F1)。中重度纤维化、合并症和伴随用药的患者更常接受较长的治疗时间。8 周治疗的患者中,186 例(94%)和 12 周治疗的患者中 558 例(97%)达到 SVR(p=0.07)。排除失访患者后,SVR 率分别达到 95%和 99%(p=0.01)。我们未能确定与无应答相关的因素。

结论

这项真实世界的经验研究证实,在非晚期纤维化的基因型 1b 丙型肝炎病毒感染患者中,采用 OPrD 8 周和 12 周治疗方案具有相似的高疗效。尽管 8 周方案的 SVR 率较低,但在大多数此类患者中,无需将治疗延长至 12 周,也无需添加利巴韦林。

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