Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Infectious Diseases, Luohe Central Hospital, Luohe, Henan, China.
J Med Virol. 2022 Sep;94(9):4548-4553. doi: 10.1002/jmv.27877. Epub 2022 Jun 1.
Data on sofosbuvir-based therapy for pregnant women and infants with severe chronic hepatitis C (CHC) are lacking. Two late pregnant women and one female infant with severe CHC were enrolled for treatment. Pregnant Women 1 and 2 and Infant 3 were 30, 33, and 1.2 years old, respectively; the gestational ages of pregnant Women 1 and 2 were 31 and 26 weeks, respectively. Notably, pregnant Women 1 and 2 and Infant 3 had hepatitis C virus (HCV) RNA levels of 139 000, 198 000, and 8 450 000 IU/ml; alanine aminotransferase levels of 420, 781, and 220 U/L; and received sofosbuvir/ledipasvir, sofosbuvir/velpatasvir, and sofosbuvir/ledipasvir for 12 weeks, respectively. All three patients were safely cured with favorable tolerance, and two newborns were both breastfeeding and were consistently negative for the anti-HCV antibody during the 1-year follow-up after birth. Additionally, two newborns and Infant 3 had normal growth parameters during the follow-up year one. In conclusion, this case series study found that sofosbuvir-based therapy for pregnant women and infants with severe CHC is safe and effective. The data may fill the gap and provide evidence of the use of sofosbuvir-based therapy as a reference when similar severe CHC situations are encountered during clinical practice.
尚无关于索磷布韦为基础的疗法治疗患有严重慢性丙型肝炎(CHC)的孕妇和婴儿的数据。本研究纳入了两名晚期妊娠妇女和一名患有严重 CHC 的女婴进行治疗。孕妇 1 和 2 及婴儿 3 的年龄分别为 30、33 和 1.2 岁;孕妇 1 和 2 的妊娠周数分别为 31 和 26 周。值得注意的是,孕妇 1 和 2 及婴儿 3 的丙型肝炎病毒(HCV)RNA 水平分别为 139000、198000 和 8450000IU/ml;丙氨酸氨基转移酶水平分别为 420、781 和 220U/L;分别接受索磷布韦/雷迪帕韦、索磷布韦/维帕他韦和索磷布韦/雷迪帕韦治疗 12 周。这 3 例患者均安全治愈,耐受性良好,2 名新生儿均接受母乳喂养,且在出生后 1 年的随访中持续抗 HCV 抗体阴性。此外,在随访的 1 年内,2 名新生儿和婴儿 3 的生长参数均正常。总之,本病例系列研究发现,索磷布韦为基础的疗法治疗患有严重 CHC 的孕妇和婴儿是安全有效的。这些数据可能填补了空白,为临床实践中遇到类似严重 CHC 情况时使用索磷布韦为基础的疗法提供了参考依据。