Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Medicina (Kaunas). 2021 Sep 18;57(9):986. doi: 10.3390/medicina57090986.
: this study assessed variations in the blood parameters of patients with hematological disorders infected with HCV throughout a 12-week interferon-free treatment regimen. We followed a total of 344 patients suffering from chronic hepatitis C, infected with the 1b genotype and concomitant hematological disorders, who benefited from the direct-acting antiviral (DAA) therapy in our clinic. Seven of the most routinely checked blood parameters were analyzed, namely, hemoglobin, leucocyte count, neutrophils, erythrocyte count, platelet count, ALT, and total bilirubin level. In total, 129 patients received a treatment scheme comprising ombitasvir, paritaprevir, ritonavir, and dasabuvir, while the 215 other patients received a sofosbuvir and ledipasvir regimen. Patients enrolled in the study showed remarkably increased ALT levels in the first four weeks of DAA treatment, normalizing to levels below 40 U/L by the end of regimen. There were no other blood parameters that worsened throughout the 12-week regimen to levels below our laboratory's normal range. After 12 weeks of DAA therapy, 309 patients (90%) achieved SVR. Our findings are consistent in evaluating the efficacy and tolerability of direct-acting antivirals for 1b genotype HCV infected patients with associated hematological malignancies under remission, and other hematological disturbances, that were previously unsuccessfully treated with a pegylated interferon regimen. Thus, paving a pathway for government-funded programs being implemented in this direction.
: 本研究评估了在无干扰素 12 周治疗方案中，患有血液系统疾病且感染 HCV 的患者的血液参数变化。我们共随访了 344 名患有慢性丙型肝炎、感染 1b 基因型且伴有血液系统疾病的患者，他们在我们的诊所接受了直接作用抗病毒 (DAA) 治疗。分析了七种最常检查的血液参数，即血红蛋白、白细胞计数、中性粒细胞、红细胞计数、血小板计数、ALT 和总胆红素水平。共有 129 名患者接受了包括奥比他韦、帕利他韦、利托那韦和达萨布韦的治疗方案，而另外 215 名患者接受了索非布韦和雷迪帕韦的治疗方案。研究中的患者在 DAA 治疗的前四周表现出明显升高的 ALT 水平，到治疗结束时恢复到低于 40 U/L 的水平。在 12 周的治疗过程中，没有其他血液参数恶化到低于我们实验室的正常范围。在 DAA 治疗 12 周后，309 名患者（90%）实现了 SVR。我们的发现与评估在缓解期患有相关血液恶性肿瘤和其他血液紊乱的 1b 基因型 HCV 感染患者的直接作用抗病毒药物的疗效和耐受性一致，这些患者以前使用聚乙二醇干扰素方案治疗不成功。因此，为实施这一方向的政府资助计划铺平了道路。
