Butt Nazish, Khan Muhammad Ali, Akbar Ali
Dr. Nazish Butt, MBBS, FCPS. Assistant Professor, Head Department of Gastroenterology, Department of Gastroenterology, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
Dr. Anoshia, MBBS, FCPS. Consultant Gastroenterologist, Department of Gastroenterology, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
Pak J Med Sci. 2021 Nov-Dec;37(7):2014-2019. doi: 10.12669/pjms.37.7.4627.
To assess the effectiveness of Sofosbuvir (SOF) and Daclatasvir (DCV) in patients with chronic hepatitis C (CHC), compensated cirrhosis (CC) and decompensated cirrhosis (DCLD) either treatment naïve or experienced.
This was a prospective, observational study, conducted from January 2017 to December 2018 at Jinnah Postgraduate Medical Centre, Karachi. All patients above 12 years of age with detectable HCV RNA PCR were included. Patients were divided into three groups: CHC, CC and DCLD. SOF and DCV for 12 or 24 weeks were given. Ribavirin (RBV) was given to treatment experienced and cirrhotic patients. Primary outcome was End of Treatment Response (ETR) and secondary outcome was Sustained Virological Response (SVR) at post treatment week 12 or 24.
Total 300 patients with mean age of 40.49 ± 13.86 were enrolled. Majority were females 174 (58%). CHC were 200 (66.6%) while cirrhotic were 100 (33.4%). Treatment naïve patients were 267 (89%) and 33 (11%) patients were experienced. Most common genotype was 3 (83%). ETR was achieved in 292 (97.33%) and SVR in 265 (88.33%) patients respectively.
SOF plus DCV with or without RBV is a highly effective treatment for chronic HCV and is still used in many centers of Pakistan. This regimen has excellent results for GT-3. The outcomes are mainly influenced by the presence or absence of cirrhosis.
评估索磷布韦（SOF）和达卡他韦（DCV）对初治或经治的慢性丙型肝炎（CHC）、代偿期肝硬化（CC）和失代偿期肝硬化（DCLD）患者的疗效。
这是一项前瞻性观察性研究，于2017年1月至2018年12月在卡拉奇真纳研究生医学中心进行。纳入所有12岁以上HCV RNA PCR检测可检出的患者。患者分为三组：CHC、CC和DCLD。给予SOF和DCV治疗12周或24周。对经治和肝硬化患者给予利巴韦林（RBV）。主要结局是治疗结束反应（ETR），次要结局是治疗后第12周或24周的持续病毒学应答（SVR）。
共纳入300例患者，平均年龄40.49±13.86岁。大多数为女性，共174例（58%）。CHC患者200例（66.6%），肝硬化患者100例（33.4%）。初治患者267例（89%），经治患者33例（11%）。最常见的基因型是3型（83%）。分别有292例（97.33%）患者实现ETR，265例（88.33%）患者实现SVR。
SOF加DCV无论是否联合RBV都是治疗慢性HCV的高效疗法，在巴基斯坦的许多中心仍在使用。该方案对基因3型有出色疗效。结局主要受是否存在肝硬化影响。
