Safarnezhad Tameshkel Fahimeh, Karbalaie Niya Mohammad Hadi, Khoonsari Mahmoodreza, Ajdarkosh Hossein, Faraji Amir Hossein, Nikkhah Mehdi, Motamed Nima, Azarkeivan Azita, Gholami Ali, Sohrabi Masood Reza, Keyvani Hossein, Zamani Farhad
Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran.
Department of Virology, Iran University of Medical Sciences, Tehran, Iran.
Middle East J Dig Dis. 2021 Jan;13(1):27-34. doi: 10.34172/mejdd.2021.200. Epub 2021 Mar 2.
BACKGROUND Direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection showed the presence of resistant-associated substitutions (RASs). The aim of the present study was to carry out a follow-up of patients with baseline RASs to report the impact of RASs on DAA therapy outcome. METHODS In a cohort study, we analyzed NS5A and NS5B RASs among nine thalassemia cases by baseline RASs. In a 2-year follow-up, we analyzed viral markers and biochemical and hematological parameters of the participants and their sustained virologic response (SVR). Statistical analyses were performed using SPSS software version 22. RESULTS RASs for HCV subtype 1a included M28V, L31M, and H58P. For subtype 1b: L28M, R30Q, S24F, and C316N. And for subtype 3a: C316S, and S24F. In patients with cirrhosis (n = 5), ALT ( = 0.001) and AST ( = 0.007) levels were significantly reduced after treatment, and creatinine level slightly increased ( = 0.025). However, no significant data was observed in non-cirrhotic patients following the treatment. CONCLUSION The present study did not show any adverse effects of DAA therapy among patients with thalassemia suffering from chronic HCV infection with baseline RASs. Furthermore, reduction in ferritin and liver stiffness levels after DAA therapy could show the efficacy of DAA in such patients.
背景 针对丙型肝炎病毒（HCV）感染的直接作用抗病毒药物（DAA）显示存在耐药相关替代（RAS）。本研究的目的是对具有基线RAS的患者进行随访，以报告RAS对DAA治疗结果的影响。方法 在一项队列研究中，我们根据基线RAS分析了9例地中海贫血病例中的NS5A和NS5B RAS。在为期2年的随访中，我们分析了参与者的病毒标志物、生化和血液学参数以及他们的持续病毒学应答（SVR）。使用SPSS 22版软件进行统计分析。结果 HCV 1a亚型的RAS包括M28V、L31M和H58P。1b亚型的有：L28M、R30Q、S24F和C316N。3a亚型的有：C316S和S24F。在肝硬化患者（n = 5）中，治疗后ALT（P = 0.001）和AST（P = 0.007）水平显著降低，肌酐水平略有升高（P = 0.025）。然而，在非肝硬化患者治疗后未观察到显著数据。结论 本研究未显示DAA治疗对患有慢性HCV感染且具有基线RAS的地中海贫血患者有任何不良影响。此外，DAA治疗后铁蛋白和肝脏硬度水平的降低可表明DAA对此类患者的疗效。
