丙型肝炎抗病毒治疗的有效性及消除丙型肝炎目标的可行性。

IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Cristina Burgui, Ramón San Miguel, Silvia Goñi-Esarte, Regina Juanbeltz, Juan Isidro Úriz-Otano, Jesús Reparaz, Maite Sarobe, José Manuel Zozaya, Jesús Castilla
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引用次数: 0

摘要

目的:第二代直接作用抗病毒药物(DAAs)在治疗慢性丙型肝炎病毒(HCV)感染的临床试验中显示出较高的疗效。本研究旨在评估在现实生活条件下的有效性及其在普通人群中消除HCV感染的能力。方法:在这项观察性队列研究中,研究了2015年至2020年在西班牙纳瓦拉开始DAA治疗的活动性HCV感染患者。持续病毒学反应(SVR),定义为治疗结束后12周无法检测到的病毒载量,直至2021年底进行评估。结果:在开始治疗的1366名hcv感染患者中,19.3% (n = 263)为hiv合并感染。首次DAA治疗后,96.6% (n = 1320/1366)的患者达到SVR, 97.7%(95%可信区间[CI] 96.6%-98.3%)的患者完成治疗(按方案分析;N = 1320/1351)。97.9% (n = 1066/1089)的单感染者和96.9% (n = 254/262)的合并感染者SVR达到。31例患者由于无反应(n = 19),依从性差(n = 9)和不良事件(n = 3)而出现病毒学失败。在接受第二次治疗的27例患者中,24例达到SVR(1例在第三次治疗后),2例死亡,1例未达到SVR的患者拒绝了第三次治疗。3例患者再次感染,再次治疗,达到SVR。在研究结束时,1344例患者(98.4%,95% CI 97.6%-98.9%)达到SVR,只有1.8%需要超过一个疗程的治疗。所有完成治疗并随访的患者均达到SVR。结论:使用DAAs,所有完成随访的活动性HCV感染患者均达到SVR,仅一小部分患者需要进行第二疗程治疗。坚持治疗对于消除丙型肝炎病毒感染至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of hepatitis C antiviral treatment and feasibility of hepatitis C elimination goal.

Objectives: Second-generation direct-acting antivirals (DAAs) have shown high efficacy in the treatment of chronic hepatitis C virus (HCV) infections in clinical trials. This study aimed to estimate the effectiveness in real-life conditions and their capacity to eliminate HCV infection in the general population.

Methods: In this observational cohort study, patients with active HCV infection who commenced DAA treatment between 2015 and 2020 in Navarre, Spain, were studied. Sustained virological response (SVR), defined as an undetectable viral load 12 weeks after the end of treatment, was evaluated until the end of 2021.

Results: Of a total 1366 HCV-infected patients that commenced treatment, 19.3% (n = 263) were HIV-coinfected. After the first DAA treatment, SVR was achieved in 96.6% (n = 1320/1366) of patients and in 97.7% (95% confidence interval [CI] 96.6%-98.3%) of those who completed treatment (per-protocol analysis; n = 1320/1351). SVR was achieved in 97.9% (n = 1066/1089) and 96.9% (n = 254/262) of mono-infected and HIV-coinfected patients, respectively. Thirty-one patients had virological failure due to non-response (n = 19), poor compliance (n = 9), and with adverse events (n = 3). Of 27 patients that received a second treatment, 24 attained SVR (one after a third treatment), two died, and one that did not achieve SVR declined a third treatment. Three patients were re-infected, re-treated, and achieved SVR. At the end of the study, 1344 patients (98.4%, 95% CI 97.6%-98.9%) had achieved SVR, and only 1.8% needed more than one course of treatment. All patients who completed the treatment and were followed-up achieved SVR.

Conclusion: With DAAs, SVR was achieved in all patients with active HCV infection who completed follow-up, and a second course of treatment was only necessary in a small proportion of patients. Adherence to treatment is essential for HCV infection elimination.

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来源期刊
Postgraduate Medicine
Postgraduate Medicine 医学-医学:内科
CiteScore
6.10
自引率
2.40%
发文量
110
审稿时长
6-12 weeks
期刊介绍: Postgraduate Medicine is a rapid peer-reviewed medical journal published for physicians. Tracing its roots back to 1916,  Postgraduate Medicine  was established by Charles Mayo, MD, as a peer-to-peer method of communicating the latest research to aid physicians when making treatment decisions, and it maintains that aim to this day. In addition to its core subscriber base, Postgraduate Medicine is distributed to hundreds of US-based physicians within internal medicine and family practice.
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