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索磷布韦为基础的疗法治疗晚期妊娠妇女和严重慢性丙型肝炎婴儿:病例系列研究。

Sofosbuvir-based therapy for late pregnant women and infants with severe chronic hepatitis C: A case series study.

机构信息

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.

出版信息

J Med Virol. 2022 Sep;94(9):4548-4553. doi: 10.1002/jmv.27877. Epub 2022 Jun 1.

Abstract

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.

摘要

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。

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