Real world study of daclatavir combined with sofosbuvir treatment in chronic hepatitis C

Chun Zhang, Luyuan Tong, Zhaowei Tong
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Abstract

Objective To investigate the efficacy and safety of daclatavir combined with sofosbuvir treatment in chronic hepatitis C (CHC) in the real world. Methods A total of 56 CHC patients administrated with daclatavir (60 mg/d) combined with sofosbuvir (400 mg/d) in Huzhou Central Hospital from February to June in 2018 were enrolled. All patients were administrated with daclatavir combined with sofosbuvir for 12 weeks and followed up for 24 weeks. The virological response and the effect of antiviral therapy on hepatic fibrosis were analyzed. Non-structural protein 5A (NS5A) region mutation sequence was detected by Sanger method. Safety and the adverse events were observed. The t test, chi-square test and Mann-Whitney U test were used to analyze the data. Results Hepatitis C virus (HCV) RNA of all patients treated with daclatavir and sofosbuvir was undectable after eight-week treatment. Sustained virological response at 12 weeks post-treatment (SVR12) was 98.1% (52/53). Gender, globulin, insulin, triglyceride and hemoglobin were correlated with virus clearance (χ2= 4.47, t=2.51, U=1.98, U=2.32 and t=2.03, respectively, all P 0.05). During the treatment, patients developed dizziness, fatigue, nausea and vomiting, panic, insomnia, sleepiness and sexual function enhancement. Conclusion Daclatavir in combination with sophobuvir shows high virological response and good safety in the treatment of chronic hepatitis C, and liver fibrosis is improved after clearance of HCV. Key words: Hepatitis C, chronic; Daclatasvir; Sofosbuvir; Real world study
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daclatavir联合索非布韦治疗慢性丙型肝炎的现实世界研究
目的探讨daclatavir联合索非布韦治疗慢性丙型肝炎(CHC)的临床疗效和安全性。方法选择2018年2 - 6月湖州市中心医院联合使用daclatavir (60 mg/d)联合sofosbuvir (400 mg/d)的CHC患者56例。所有患者均给予daclatavir联合sofosbuvir治疗12周,随访24周。分析病毒学反应及抗病毒治疗对肝纤维化的影响。Sanger法检测非结构蛋白5A (NS5A)区突变序列。观察安全性和不良事件。采用t检验、卡方检验和Mann-Whitney U检验对数据进行分析。结果所有使用daclatavir和sofosbuvir治疗的患者在治疗8周后,丙型肝炎病毒(HCV) RNA均不可逆转。治疗后12周的持续病毒学应答(SVR12)为98.1%(52/53)。性别、球蛋白、胰岛素、甘油三酯、血红蛋白与病毒清除率相关(χ2= 4.47, t=2.51, U=1.98, U=2.32, t=2.03, P均为0.05)。治疗过程中,患者出现头晕、乏力、恶心呕吐、惊恐、失眠、嗜睡、性功能增强等症状。结论Daclatavir联合sophobuvir治疗慢性丙型肝炎病毒学反应高,安全性好,清除HCV后肝纤维化得到改善。关键词:丙型肝炎;慢性;Daclatasvir;Sofosbuvir;真实世界研究
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