Department of Infectious Diseases, Voivodeship Hospital and Jan Kochanowski University, Kielce, Poland.
Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland.
Adv Med Sci. 2020 Mar;65(1):12-17. doi: 10.1016/j.advms.2019.09.002. Epub 2019 Dec 13.
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.
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).
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.
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.
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。
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。
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。
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。