Li Guanghui, Ma Junjie, Xu Lu, Fang Jiali, Zhang Lei, Wu Jialin, Lai Xingqiang, Liu Luhao, Xiong Yunyi, Yin Wei, Zhang Tao, Zhang Peng, Li Li, Chen Rongxin, Wang Jiao, Chen Zheng
Department of Organ Transplantation, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China.
Transl Androl Urol. 2020 Apr;9(2):583-590. doi: 10.21037/tau.2020.01.05.
To explore the safety and efficacy of direct antiviral therapy in patients with hepatitis C virus (HCV) infection after renal transplantation.
We retrospectively reviewed the medical information of 15 cases of HCV patients treated with direct antiviral therapy after renal transplantation in our center. The effectiveness of direct antiviral therapy was evaluated by analyzing the HCV-RNA levels of patients at 1, 4, 12, 24, and 48 weeks before and after antiviral therapy. In addition, parameters including the rejection rate, the blood concentration of anti-rejection drugs, liver function level [alanine aminotransferase (ALT), aspartate transaminase (AST)], estimated glomerular filtration rate (eGFR) and serum creatinine (CREA) levels were used to assess its safety.
A total of 15 patients were enrolled in the study. All patients turned HCV-RNA negative after 12 weeks of direct-antiviral therapy; the serological test of all patients demonstrated an 100% response rate in rapid virological response (RVR) (15/15), 12-week sustained virological response (SVR12), and 24-week sustained virological response (SVR24). In addition, compared to pre-treatment, the liver function within 12, 24, and 48 weeks after treatment was significantly improved. Moreover, eGFR, CREA, and anti-rejection drug concentration remained stable while acute rejection reaction and other obvious side effects were not observed throughout the treatment period.
The direct antiviral therapy was well-tolerated and effective for patients with chronic hepatitis C after renal transplantation.
探讨直接抗病毒疗法在肾移植后丙型肝炎病毒(HCV)感染患者中的安全性和有效性。
我们回顾性分析了本中心15例肾移植后接受直接抗病毒治疗的HCV患者的医疗信息。通过分析抗病毒治疗前后1、4、12、24和48周患者的HCV-RNA水平来评估直接抗病毒治疗的有效性。此外,使用包括排斥反应发生率、抗排斥药物血药浓度、肝功能水平[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)]、估计肾小球滤过率(eGFR)和血清肌酐(CREA)水平等参数来评估其安全性。
共纳入15例患者进行研究。所有患者在接受12周直接抗病毒治疗后HCV-RNA均转为阴性;所有患者的血清学检测显示快速病毒学应答(RVR)(15/15)、12周持续病毒学应答(SVR12)和24周持续病毒学应答(SVR24)的应答率均为100%。此外,与治疗前相比,治疗后12、24和48周时肝功能显著改善。而且,eGFR、CREA和抗排斥药物浓度保持稳定,整个治疗期间未观察到急性排斥反应及其他明显副作用。
直接抗病毒疗法对肾移植后慢性丙型肝炎患者耐受性良好且有效。