实用肝脏病杂志2024，Vol.27Issue(2)：181-184,4.DOI:10.3969/j.issn.1672-5069.2024.02.006
减量索磷布韦联合全量达卡他韦治疗终末期肾病合并急性丙型肝炎患者临床疗效研究
Similar virological response to half-dose of sofosbuvir and full-dose of daclatasvir therapy in patients with end-stage renal disease and acute hepatitis C
摘要
Abstract
Objective The aim of this study was to observe the virological response to half-dose of sofosbuvir and full-dose of daclatasvir therapy in patients with end-stage renal disease(ESRD)and acute hepatitis C(AHC).Methods 49 patients with ESRD and AHC who underwent long-term hemodialysis in our hospital were enrolled between June 2020 and January 2022,and were randomly divided into observation(n=25)and control(n=24)groups,receiving half-dose of sofosbuvir and full-dose of daclatasvir or full-dose of sofosbuvir and full-dose of daclatasvir antiviral therapy for 12 weeks.Serum HCV RNA load was detected by RT-PCR,and the peripheral blood T lymphocyte subsets were detected by flow cytometry.Results The rapid virological response,end-of-treatment virological response,12-week sustained virological response(SVR12)and SVR24 in the observation group were 72.0%,96.0%,88.0%and 88.0%,not significantly different compared to 70.8%,95.8%,87.5%and 87.5%in the control group(P＞0.05);at the end of antiviral treatment,the estimated glomerular filtration ratein the observation group was(12.5±1.0)ml/min·1.73m2,much higher than[(9.0±1.0)ml/min·1.73m2,P＜0.05],while serum creatinine level was(448.5±11.7)μmol/L,much lower than[(477.4±12.6)μmol/L,P＜0.05]in the control;there were no significant differences as respect to the percentages of peripheral blood CD4+cells and CD8+cell as well as the CD4+/CD8+cell ratio between the two groups at the end of antiviral treatment or of the follow-up(P＞0.05);the incidence of untoward effects in the observation group during the antiviral therapy was 4.0%,much lower than 25.0%(P＜0.05)in the control group.Conclusion The modified half-dose of sofosbuvir and full-dose of daclatasvirin treating patients with ESRD and AHC is relatively efficacious,which might meet the request of antiviral therapy and the reduction of renal function injury,and needs multi-central verification.关键词
丙型肝炎/终末期肾病/索磷布韦/达卡他韦/治疗Key words
Hepatitis C/End-stage renal disease/Sofosbuvir/Daclatasvir/Therapy引用本文复制引用
于欣欣,付朝霞,薛莉..减量索磷布韦联合全量达卡他韦治疗终末期肾病合并急性丙型肝炎患者临床疗效研究[J].实用肝脏病杂志,2024,27(2):181-184,4.基金项目
青岛市科技局科研基金资助项目(编号:2021LK03140) （编号:2021LK03140）
