Sheikh Naukhaiz Taqi, Shaukat Muhammad Taha, Hussain Azhar, Ayyan Ahmed, Iqbal Abdullah, Karim Shakiba, Ilyas Hasan, Ullah Kaleem, Tahir Muhammad Junaid, Asghar Muhammad Sohaib
Lahore General Hospital, Lahore, Pakistan.
Liver Transplant and Hepatobiliary Unit, Pir Abdul Qadir Shah Jelani Institute of Medical Sciences, Gambat, Sindh, Pakistan.
Ann Med Surg (Lond). 2022 Jul 20;80:104193. doi: 10.1016/j.amsu.2022.104193. eCollection 2022 Aug.
Multiple prospective and retrospective cohort studies from the West have demonstrated the conflicting results about the efficacy of direct-acting antivirals (DAAs) by sustained virologic response (SVR) achievement rate in hepatitis C virus (HCV) infected patients. But there is limited to no data about the effectiveness of triple therapy ribavirin-sofosbuvir-daclatasvir in cirrhotic hepatitis C infected patients from Pakistan.
We conducted a retrospective cohort study by retrieving records of 359 hepatitis C infected patients treated with triple therapy from two tertiary care hospitals in Pakistan [Cirrhotic = 187 (53%); non-cirrhotic = 172 (47%)] from February 18, 2018, to June 29, 2019. We lost the follow-up of 158 (44.1%) patients due to death (n = 24, 6.68%), non-responding/wrong contact number (n = 43, 9.63%), and whom consented to study but didn't complete follow-up/refused to participate in the study (n = 91, 25.34%). Only 201 (45.9%) completed follow up, and of these 87 (43.2%) were cirrhotic patients based on Liver Stiffness Index. Analysis was run by dividing groups into subgroups; who achieved SVR/who didn't achieve SVR.
We analyzed the data of 201 (45.9%) who completed follow-up including cirrhotic patients (n = 87, 43.2%). Mean age was 50.6 + 10.65 years. 81 (94.18%) did achieve SVR while 5 (5.81%) did not achieve SVR. Achievement of SVR was statistically associated with low platelet count, higher total bilirubin, and lower albumin (p < 0.05) while other demographic and disease-related characteristics of patients were not statistically significant (p > 0.05).
Triple therapy (ribavirin-sofosbuvir-daclatasvir) achieves over 94% SVR in the Pakistani population, so proved to be highly effective against hepatitis C infection.
西方多项前瞻性和回顾性队列研究显示，在丙型肝炎病毒（HCV）感染患者中，直接抗病毒药物（DAA）通过持续病毒学应答（SVR）达成率所体现的疗效存在相互矛盾的结果。但关于巴基斯坦肝硬化丙型肝炎感染患者使用利巴韦林-索磷布韦-达卡他韦三联疗法的有效性，相关数据极为有限或几乎没有。
我们进行了一项回顾性队列研究，从巴基斯坦两家三级医疗医院检索了2018年2月18日至2019年6月29日期间接受三联疗法治疗的359例丙型肝炎感染患者的记录[肝硬化患者 = 187例（53%）；非肝硬化患者 = 172例（47%）]。由于死亡（n = 24，6.68%）、无应答/联系电话错误（n = 43，9.63%）以及同意参与研究但未完成随访/拒绝参与研究（n = 91，25.34%），我们失去了158例（44.1%）患者的随访。仅有201例（45.9%）完成了随访，其中根据肝脏硬度指数，87例（43.2%）为肝硬化患者。分析通过将患者分为实现SVR/未实现SVR的亚组进行。
我们分析了201例（45.9%）完成随访患者的数据，其中包括肝硬化患者（n = 87，43.2%）。平均年龄为50.6 ± 10.65岁。81例（94.18%）实现了SVR，而5例（5.81%）未实现SVR。SVR的达成与低血小板计数、较高的总胆红素和较低的白蛋白具有统计学相关性（p < 0.05），而患者的其他人口统计学和疾病相关特征无统计学意义（p > 0.05）。
三联疗法（利巴韦林-索磷布韦-达卡他韦）在巴基斯坦人群中实现了超过94%的SVR，因此被证明对丙型肝炎感染具有高度疗效。
