器官移植2017，Vol.8Issue(1)：49-53,5.DOI:10.3969/j.issn.1674-7445.2017.01.010
直接抗病毒药物治疗肾移植术后丙型病毒性肝炎疗效与安全性的临床观察
Preliminary observation of clinical efifcacy and safety of direct-acting antiviral agents for hepatitis C virus following renal ;transplantation
摘要
Abstract
Objective To observe the clinical efficacy and safety of direct-acting antiviral agents(DAAs)in the treatment of hepatitis C after renal transplantation. Methods Six patients were complicated with hepatitis C virus(HCV) at 8 to 43 months after renal transplantation with a median time of 19 months. Prior to treatment, the virus load was detected from 4.03×103 to 8.18×107 IU/mL. Four cases were administered with tacrolimus(FK506)+mycophenolate mofetil(MMF)+prednisone(Pred), and the remaining 2 received cyclosporin(CsA)+MMF+Pred. The serum creatinine level was lower than 200μmol/L. The amount of urine and body weight remained stable. No severe mental irritation or trauma history wasreportedwithin6monthsbeforeantiviraltherapy.SixpatientsdidnotreceivegenotypetestofHCVbeforeDAAstherapy. Fourpatientswereadministeredwithsofosbuvir,1withsofosbuvir+ledipavirand1withsofosbuvir+daclatasvirfor12weeks. The complete blood cel count, serum transaminase level, creatinine level and blood concentration of immunosuppressive agents were measured each week and serum HCV RNA level was quantitatively detected every 4 weeks. Results Among 6 patients, 5 were negative for HCV at 4 weeks after DAAs therapy and obtained sustained virological response(SVR)after DAAs treatment. One case administered with sofosbuvir alone was positive for HCV after DAAs therapy. The patient was infected with genotype 5 HCV. After 12-week administration of sofosbuvir+daclatasvir, the patient was negative for HCV and obtained SVR. No significant changes were observed in complete blood cel count, serum transaminase level, creatinine level and blood concentration of immunosuppressive agents. Adverse reactions included evanescent eruption in 1 case and mild dizziness in 1 case. Conclusions DAAs treatment is an effective and safe approach for patients with stable renal function after renal transplantation. Combined use of sofosbuvir+daclatasvir is recommended as the optimal therapy.关键词
直接抗病毒药物/肾移植/丙型病毒性肝炎/索非布韦/达卡他韦/雷迪帕韦/疗效/安全性Key words
Uirect-acting antiviral agent/Renal transplantation/Hepatitis C/Sofosbuvir/Daclatasvir/Ledipavir/Efficacy/Safety分类
医药卫生引用本文复制引用
牛英,明英姿,佘兴国,刘洪..直接抗病毒药物治疗肾移植术后丙型病毒性肝炎疗效与安全性的临床观察[J].器官移植,2017,8(1):49-53,5.基金项目
吴阶平医学基金会临床科研专项资助基金 （）
